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General NPI Number Information
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NPI Number | 1700181864
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Entity Type | Organization
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Legal Business Name | FOREVER GREEN ACUPUNCTURE
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Dates
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Enumeration Date | 01/21/2011
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Last Update Date | 01/21/2011
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Provider Practice Location Address
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Address Line | 3850 WILSHIRE BL #220
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City | LOS ANGELES
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State | CA
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Zip | 90010
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Country | US
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Telephone | 213-382-2349
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Fax | 213-325-2177
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Provider Business Mailing Address
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Address Line | 3850 WILSHIRE BL #220
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City | LOS ANGELES
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State | CA
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Zip | 90010
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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 | SANG YOU
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Credential |
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Telephone | 213-382-2349
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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 | 10677
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License Number State | CA
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