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General NPI Number Information
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NPI Number | 1972879963
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Entity Type | Individual
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Provider Name | JANE SUH
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Gender | Female
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Dates
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Enumeration Date | 03/24/2012
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Last Update Date | 03/24/2012
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Provider Practice Location Address
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Address Line | 4010 BARRANCA PKWY STE 250
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City | IRVINE
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State | CA
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Zip | 92604-1724
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Country | US
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Telephone | 949-551-0023
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Fax | 949-551-0024
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Provider Business Mailing Address
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Address Line | 4010 BARRANCA PKWY STE 250
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City | IRVINE
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State | CA
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Zip | 92604-1724
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Country | US
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Telephone | 949-551-0023
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Fax | 949-551-0024
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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 | AC9815
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License Number State | CA
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