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NPI Code Detail

MEDICARE: WON ACUPUNCTURE CLINIC, INC.

MEDICARE: WON 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
1171100000XAcupuncturistAC9468CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AC9468OTHERCACA LICENSE

General Provider Information

NPI Number : 1568642247
Entity Type Code : Organization
Provider Name (Legal Business Name) : WON ACUPUNCTURE CLINIC, INC.
Provider Business Mailing Address
First Line : 3407 W. 6TH ST.
Second Line : 615
City : LOS ANGELES
State : CA
Zip : 90020-2553
Country : US
Telephone Number : 323-730-9900
Fax Number :
Provider Business Practice Location Address
First Line : 3407 W. 6TH ST.
Second Line : 615
City : LOS ANGELES
State : CA
Zip : 90020-2553
Country : US
Telephone Number : 323-730-9900
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : HYUK WON LEE
Credential : L.AC
Telephone Number : 323-730-9900
Provider Enumeration Date : 11/09/2007
Last Update Date : 04/15/2016

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