Provider Demographics
NPI:1144797879
Name:SCL ACUPUNCTURE
Entity Type:Organization
Organization Name:SCL ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SEUNG CHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIM
Authorized Official - Suffix:
Authorized Official - Credentials:ACUPUNCTURIST
Authorized Official - Phone:714-865-5034
Mailing Address - Street 1:729 S HOBART BLVD APT 38
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90005-2837
Mailing Address - Country:US
Mailing Address - Phone:714-865-5034
Mailing Address - Fax:
Practice Address - Street 1:2426 W 8TH ST STE 203
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-3872
Practice Address - Country:US
Practice Address - Phone:714-865-5034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-31
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty