MEDICARE: CORE ACUPUNCTURE HEALTH CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist
2	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1003097429
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORE ACUPUNCTURE HEALTH CARE

Provider Business Mailing Address
First Line	:	6031 BEACH BLVD
Second Line	:
City	:	BUENA PARK
State	:	CA
Zip	:	90621-2304
Country	:	US
Telephone Number	:	714-994-1169
Fax Number	:

Provider Business Practice Location Address
First Line	:	6031 BEACH BLVD
Second Line	:
City	:	BUENA PARK
State	:	CA
Zip	:	90621-2304
Country	:	US
Telephone Number	:	714-994-1169
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. YOUNGHEE PARK
Credential	:	D.C., L.AC., OMD
Telephone Number	:	714-994-1169

Provider Enumeration Date	:	11/14/2007
Last Update Date	:	11/14/2007

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