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General NPI Number Information
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NPI Number | 1669848479
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Entity Type | Organization
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Legal Business Name | UNION ACUPUNCTURE CLINIC
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Dates
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Enumeration Date | 08/15/2015
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Last Update Date | 08/15/2015
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Provider Practice Location Address
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Address Line | 32245 MISSION TRL STE. D6
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City | LAKE ELSINORE
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State | CA
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Zip | 92530-4528
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Country | US
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Telephone | 951-674-8683
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Fax | 951-674-1763
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Provider Business Mailing Address
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Address Line | 32245 MISSION TRL STE. D6
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City | LAKE ELSINORE
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State | CA
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Zip | 92530-4528
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Country | US
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Telephone | 951-674-8683
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Fax | 951-674-1763
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | DR. DANIEL SANG NAM
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Credential | L.AC.
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Telephone | 951-833-4699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 5993
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License Number State | CA
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