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General NPI Number Information
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NPI Number | 1790196913
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Entity Type | Organization
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Legal Business Name | ONNURI-3004,INC.
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Dates
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Enumeration Date | 05/09/2014
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Last Update Date | 05/09/2014
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Provider Practice Location Address
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Address Line | 250 N ROBERTSON BLVD STE 516
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-1789
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Country | US
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Telephone | 310-859-7696
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Fax | 310-859-7699
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Provider Business Mailing Address
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Address Line | 250 N ROBERTSON BLVD STE 516
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-1789
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Country | US
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Telephone | 310-859-7696
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Fax | 310-859-7699
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Authorized Official
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Title or Position | OWNER/ ACUPUNCTURIST
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Name | DR. EUN J SONG
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Credential | L.AC. PH.D.
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Telephone | 310-859-7696
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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 | AC8225
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License Number State | CA
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