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General NPI Number Information
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NPI Number | 1922466523
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Entity Type | Organization
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Legal Business Name | ANGELA KUNG ACUPUNCTURE & WELLNESS CENTER
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Dates
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Enumeration Date | 02/10/2016
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Last Update Date | 01/24/2017
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Provider Practice Location Address
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Address Line | 27405 PUERTA REAL SUITE 210
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City | MISSION VIEJO
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State | CA
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Zip | 92691-6314
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Country | US
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Telephone | 949-420-1338
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Fax | 949-420-1326
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Provider Business Mailing Address
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Address Line | 27405 PUERTA REAL SUITE 210
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City | MISSION VIEJO
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State | CA
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Zip | 92691-6314
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Country | US
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Telephone | 949-420-1338
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Fax | 949-420-1326
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Authorized Official
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Title or Position | OWNER/CEO/ACUPUNCTURIST
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Name | ANGELA KUNG
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Credential | L.AC
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Telephone | 949-420-1338
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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 | 13865
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License Number State | CA
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