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General NPI Number Information
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NPI Number | 1922564277
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Entity Type | Individual
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Provider Name | JUN HO BEON LIC. AC
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Gender | Male
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Dates
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Enumeration Date | 02/12/2019
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Last Update Date | 02/12/2019
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Provider Practice Location Address
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Address Line | 751 S VERMONT AVE
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City | LOS ANGELES
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State | CA
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Zip | 90005-1518
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Country | US
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Telephone | 213-249-1090
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 743134
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City | LOS ANGELES
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State | CA
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Zip | 90004-0931
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Country | US
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Telephone | 213-290-2848
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | AC5294
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License Number State | CA
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