MEDICARE: MILIM JEON

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	13948	CA

General Provider Information

NPI Number	:	1366719791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MILIM JEON

Provider Business Mailing Address
First Line	:	408 WESTMINSTER AVE
Second Line	:	SUITE 7
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663
Country	:	US
Telephone Number	:	949-282-8991
Fax Number	:

Provider Business Practice Location Address
First Line	:	408 WESTMINSTER AVE
Second Line	:	SUITE 7
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663-4238
Country	:	US
Telephone Number	:	949-282-8991
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2011
Last Update Date	:	11/30/2011

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Directions to “ MILIM JEON ” Practice Location

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