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General NPI Number Information
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NPI Number | 1902404247
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Entity Type | Organization
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Legal Business Name | ARBOL ACUPUNCTURE
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Dates
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Enumeration Date | 10/09/2020
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Last Update Date | 10/09/2020
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Provider Practice Location Address
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Address Line | 2620 FOOTHILL BLVD STE A
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City | LA CRESCENTA
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State | CA
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Zip | 91214-4509
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Country | US
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Telephone | 213-909-4035
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Fax |
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Provider Business Mailing Address
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Address Line | 2620 FOOTHILL BLVD STE A
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City | LA CRESCENTA
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State | CA
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Zip | 91214-4509
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Country | US
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Telephone | 213-909-4035
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Fax |
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Authorized Official
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Title or Position | C.E.O.
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Name | JEONG HOON KIM
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Credential | L.AC.
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Telephone | 213-909-4035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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