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General NPI Number Information
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NPI Number | 1881905339
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Entity Type | Organization
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Legal Business Name | KRIS ACUPUNCTURE, INC
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Dates
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Enumeration Date | 06/30/2010
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Last Update Date | 06/30/2010
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Provider Practice Location Address
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Address Line | 8322 GARDEN GROVE BL
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City | GARDEN GROVE
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State | CA
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Zip | 92844
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Country | US
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Telephone | 714-590-1426
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Fax | 714-590-1457
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Provider Business Mailing Address
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Address Line | 8322 GARDEN GROVE BL
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City | GARDEN GROVE
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State | CA
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Zip | 92844
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Country | US
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Telephone | 714-590-1426
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Fax | 714-590-1457
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Authorized Official
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Title or Position | PRESIDENT
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Name | KWANGBUM LEE
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Credential | LAC
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Telephone | 714-590-1426
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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 | AC8176
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License Number State | CA
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