Provider Demographics
NPI:1083867220
Name:O HAENG ACUPUNCTURE,INC
Entity Type:Organization
Organization Name:O HAENG ACUPUNCTURE,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:SEONGUK
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIM
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:951-696-2779
Mailing Address - Street 1:40680 CALIFORNIA OAKS RD
Mailing Address - Street 2:SUITE 2-D
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-5755
Mailing Address - Country:US
Mailing Address - Phone:951-696-2779
Mailing Address - Fax:951-696-2778
Practice Address - Street 1:40680 CALIFORNIA OAKS RD
Practice Address - Street 2:SUITE 2-D
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-5755
Practice Address - Country:US
Practice Address - Phone:951-696-2779
Practice Address - Fax:951-696-2778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-31
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC10222171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty