Provider Demographics
NPI:1003285784
Name:BEST OMD ACUPUNCTURE
Entity Type:Organization
Organization Name:BEST OMD ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOO HEE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-974-0213
Mailing Address - Street 1:1781 W ROMNEYA DR STE D
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-1818
Mailing Address - Country:US
Mailing Address - Phone:657-230-9113
Mailing Address - Fax:323-400-6306
Practice Address - Street 1:1781 W ROMNEYA DR STE D
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1818
Practice Address - Country:US
Practice Address - Phone:657-230-9113
Practice Address - Fax:323-400-6306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-23
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC15696171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty