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NPI Code Detail

MEDICARE: JA DEUK HANBANG CLINIC

MEDICARE: JA DEUK HANBANG 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
1171100000XAcupuncturistAC11995CA

General Provider Information

NPI Number : 1396996138
Entity Type Code : Organization
Provider Name (Legal Business Name) : JA DEUK HANBANG CLINIC
Provider Business Mailing Address
First Line : 3030 W OLYMPIC BLVD
Second Line : 210
City : LOS ANGELES
State : CA
Zip : 90006-6501
Country : US
Telephone Number : 213-365-1758
Fax Number : 213-365-1709
Provider Business Practice Location Address
First Line : 3030 W OLYMPIC BLVD
Second Line : 210
City : LOS ANGELES
State : CA
Zip : 90006-6501
Country : US
Telephone Number : 213-365-1758
Fax Number : 213-365-1709
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : YUNKYUNG KIM
Credential :
Telephone Number : 213-365-1758
Provider Enumeration Date : 10/09/2008
Last Update Date : 01/19/2011

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Directions to “JA DEUK HANBANG CLINIC ” Practice Location

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