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General NPI Number Information
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NPI Number | 1720422256
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Entity Type | Organization
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Legal Business Name | BIJOU SKINCARE & ACUPUNCTURE
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Dates
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Enumeration Date | 04/26/2013
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Last Update Date | 04/26/2013
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Provider Practice Location Address
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Address Line | 1401 S BEACH BLVD SUITE G1
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City | LA HABRA
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State | CA
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Zip | 90631-6377
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Country | US
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Telephone | 562-943-1234
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Fax | 562-943-3000
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Provider Business Mailing Address
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Address Line | 1401 S BEACH BLVD SUITE G1
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City | LA HABRA
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State | CA
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Zip | 90631-6377
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Country | US
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Telephone | 562-943-1234
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Fax | 562-943-3000
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Authorized Official
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Title or Position | L.AC. / PRESIDENT
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Name | YUNJA PARK
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Credential |
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Telephone | 562-943-1234
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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 | AC 12339
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License Number State | CA
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