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General NPI Number Information
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NPI Number | 1841585056
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Entity Type | Organization
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Legal Business Name | PARK'S ACUPUNCTURE CLINIC & HERBS
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Dates
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Enumeration Date | 06/15/2011
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Last Update Date | 04/25/2017
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Provider Practice Location Address
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Address Line | 650 ALAMO PINTADO RD STE 104
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City | SOLVANG
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State | CA
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Zip | 93463-2266
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Country | US
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Telephone | 805-686-0805
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Fax | 805-728-7193
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Provider Business Mailing Address
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Address Line | 650 ALAMO PINTADO RD STE 104
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City | SOLVANG
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State | CA
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Zip | 93463-2266
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Country | US
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Telephone | 805-686-0805
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Fax | 805-728-7193
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | SAEONG BIN PARK
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Credential | L.AC
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Telephone | 805-686-0805
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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 | 7811
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License Number State | CA
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