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NPI Code Detail

MEDICARE: SOUTH BAYLO UNIVERSITY

MEDICARE: SOUTH BAYLO UNIVERSITY
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
1171100000XAcupuncturist

General Provider Information

NPI Number : 1235483025
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTH BAYLO UNIVERSITY
Provider Business Mailing Address
First Line : 2727 W 6TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-3111
Country : US
Telephone Number : 213-738-1974
Fax Number : 213-738-1923
Provider Business Practice Location Address
First Line : 2727 W 6TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-3111
Country : US
Telephone Number : 213-738-1974
Fax Number : 213-738-1923
Authorized Official
Title or Position : CLINIC DIRECTOR
Name : PROF. DEUK S JANG
Credential : O.M.D., L.AC
Telephone Number : 213-738-1974
Provider Enumeration Date : 11/01/2012
Last Update Date : 03/24/2017

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Directions to “SOUTH BAYLO UNIVERSITY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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