MEDICARE: LAFFA-ACU CLINIC

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	AC12353	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AC12353	OTHER	CA	LICENSE

General Provider Information

NPI Number	:	1154594497
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAFFA-ACU CLINIC

Provider Business Mailing Address
First Line	:	1930 WILSHIRE BLVD STE 206
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-3612
Country	:	US
Telephone Number	:	213-483-1223
Fax Number	:	213-483-1130

Provider Business Practice Location Address
First Line	:	1930 WILSHIRE BLVD STE 206
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-3612
Country	:	US
Telephone Number	:	213-483-1223
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	SOPHIA RHEE
Credential	:	L.AC
Telephone Number	:	213-483-1223

Provider Enumeration Date	:	04/08/2008
Last Update Date	:	09/19/2013

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Directions to “LAFFA-ACU CLINIC ” Practice Location

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