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General NPI Number Information
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NPI Number | 1689953259
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Entity Type | Organization
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Legal Business Name | THE GOOD & LOTUS, INC.
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Dates
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Enumeration Date | 08/12/2011
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Last Update Date | 08/12/2011
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Provider Practice Location Address
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Address Line | 1041 E YORBA LINDA BLVD # 310
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City | PLACENTIA
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State | CA
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Zip | 92870-3728
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Country | US
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Telephone | 714-732-7319
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Fax |
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Provider Business Mailing Address
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Address Line | 1041 E YORBA LINDA BLVD # 310
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City | PLACENTIA
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State | CA
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Zip | 92870-3728
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEE YOUNG KWON
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Credential |
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Telephone | 714-732-7319
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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 | AC12469
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License Number State | CA
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