Provider Demographics
NPI:1043764194
Name:GOJEO ACUPUNCTURE CLINIC INC
Entity Type:Organization
Organization Name:GOJEO ACUPUNCTURE CLINIC INC
Other - Org Name:GOJEO ACUPUNCTURE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SEUNG KYO
Authorized Official - Middle Name:
Authorized Official - Last Name:JEONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-538-4787
Mailing Address - Street 1:115 E LIVE OAK AVE # 102
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-5241
Mailing Address - Country:US
Mailing Address - Phone:626-538-4787
Mailing Address - Fax:626-538-4787
Practice Address - Street 1:115 E LIVE OAK AVE # 102
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-5241
Practice Address - Country:US
Practice Address - Phone:626-538-4787
Practice Address - Fax:626-538-4787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-06
Last Update Date:2016-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC10520171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty