Provider Demographics
NPI:1083236814
Name:MBR ACUPUNCTURE & HERB, INC.
Entity Type:Organization
Organization Name:MBR ACUPUNCTURE & HERB, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KYU OK
Authorized Official - Middle Name:
Authorized Official - Last Name:CHO
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:858-866-6081
Mailing Address - Street 1:8303 CLAIREMONT MESA BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-1326
Mailing Address - Country:US
Mailing Address - Phone:858-866-6081
Mailing Address - Fax:858-715-3990
Practice Address - Street 1:8303 CLAIREMONT MESA BLVD STE 104
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-1326
Practice Address - Country:US
Practice Address - Phone:858-866-6081
Practice Address - Fax:858-715-3990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-14
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty