MEDICARE: HYO SONG ACUPUNTURIST

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	AC11181	CA

General Provider Information

NPI Number	:	1750607875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HYO SONG ACUPUNTURIST

Provider Business Mailing Address
First Line	:	408 S BEACH BLVD STE 108
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92804-1875
Country	:	US
Telephone Number	:	714-821-7900
Fax Number	:	714-821-7901

Provider Business Practice Location Address
First Line	:	408 S BEACH BLVD #108
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92804-1875
Country	:	US
Telephone Number	:	714-821-7900
Fax Number	:	714-821-7901

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

Provider Enumeration Date	:	04/14/2010
Last Update Date	:	04/14/2010

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Directions to “ HYO SONG ACUPUNTURIST” Practice Location

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