MEDICARE: EAST & WEST ACUPUNCTURE CLINIC INC.

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	AC8586	CA

General Provider Information

NPI Number	:	1528570074
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAST & WEST ACUPUNCTURE CLINIC INC.

Provider Business Mailing Address
First Line	:	30313 CANWOOD ST STE 23
Second Line	:
City	:	AGOURA HILLS
State	:	CA
Zip	:	91301-2034
Country	:	US
Telephone Number	:	818-889-8988
Fax Number	:	818-889-7787

Provider Business Practice Location Address
First Line	:	30313 CANWOOD ST STE 23
Second Line	:
City	:	AGOURA HILLS
State	:	CA
Zip	:	91301-2034
Country	:	US
Telephone Number	:	818-889-8988
Fax Number	:	818-889-7787

Authorized Official
Title or Position	:	OWNER
Name	:	HYONGOAK DU
Credential	:	LAC.
Telephone Number	:	818-889-8988

Provider Enumeration Date	:	10/24/2017
Last Update Date	:	10/24/2017

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Directions to “EAST & WEST ACUPUNCTURE CLINIC INC. ” Practice Location

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