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General NPI Number Information
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NPI Number | 1972159531
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Entity Type | Organization
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Legal Business Name | LUZWAVE HEALTHY PATHWAYS INC.
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Dates
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Enumeration Date | 08/09/2019
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Last Update Date | 08/09/2019
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Provider Practice Location Address
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Address Line | 14662 NEWPORT AVE STE 105
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City | TUSTIN
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State | CA
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Zip | 92780-6064
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Country | US
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Telephone | 949-540-5486
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Fax |
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Provider Business Mailing Address
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Address Line | 17 SPECTRUM POINTE DR STE 506
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City | LAKE FOREST
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State | CA
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Zip | 92630-2277
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Country | US
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Telephone | 949-533-6699
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | EUI SOON KIM
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Credential |
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Telephone | 949-540-5486
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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 |
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License Number State |
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