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General NPI Number Information
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NPI Number | 1760750699
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Entity Type | Organization
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Legal Business Name | SUN ACUPUNCTURE & HEALING CENTER
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Dates
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Enumeration Date | 12/07/2011
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Last Update Date | 12/07/2011
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Provider Practice Location Address
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Address Line | 1300 25TH AVE STE 100
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City | SAN FRANCISCO
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State | CA
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Zip | 94122-1563
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Country | US
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Telephone | 415-766-5678
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Fax | 415-373-1708
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Provider Business Mailing Address
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Address Line | 1300 25TH AVE STE 100
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City | SAN FRANCISCO
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State | CA
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Zip | 94122-1563
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Country | US
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Telephone | 415-766-5678
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Fax | 415-373-1708
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | KYUNGYEOL LEE
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Credential | L,AC
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Telephone | 415-766-5678
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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 | 11924
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License Number State | CA
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