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NPI Code Detail

MEDICARE: JULIA CHING HUI SU L.AC.

MEDICARE: JULIA CHING HUI SU L.AC.
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
1171100000XAcupuncturist12989CA

General Provider Information

NPI Number : 1912141383
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIA CHING HUI SU L.AC.
Provider Business Mailing Address
First Line : 616 EYRE CIR
Second Line :
City : PLACENTIA
State : CA
Zip : 92870-4276
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2361 S AZUSA AVE
Second Line :
City : WEST COVINA
State : CA
Zip : 91792-1537
Country : US
Telephone Number : 626-965-2334
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2009
Last Update Date : 04/28/2009

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