Provider Demographics
NPI:1215231915
Name:OH, JAMES (LAC, PHD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:OH
Suffix:
Gender:M
Credentials:LAC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 W OLYMPIC BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-3704
Mailing Address - Country:US
Mailing Address - Phone:213-389-3929
Mailing Address - Fax:213-389-3969
Practice Address - Street 1:1940 W OLYMPIC BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-3704
Practice Address - Country:US
Practice Address - Phone:213-389-3929
Practice Address - Fax:213-389-3969
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-10
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5093171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist