Provider Demographics
NPI:1053687392
Name:OH, JEEMEEN (L AC)
Entity Type:Individual
Prefix:
First Name:JEEMEEN
Middle Name:
Last Name:OH
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1918 POMAR WAY
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-1429
Mailing Address - Country:US
Mailing Address - Phone:415-407-7834
Mailing Address - Fax:
Practice Address - Street 1:1918 POMAR WAY
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-1429
Practice Address - Country:US
Practice Address - Phone:415-407-7834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-30
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC14709171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist