Provider Demographics
NPI:1235901307
Name:RODEM ACUPUNCTURE, INC
Entity Type:Organization
Organization Name:RODEM ACUPUNCTURE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HYOUNGGUN
Authorized Official - Middle Name:
Authorized Official - Last Name:AN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:714-319-6400
Mailing Address - Street 1:945 S WESTERN AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-1008
Mailing Address - Country:US
Mailing Address - Phone:323-641-7500
Mailing Address - Fax:
Practice Address - Street 1:945 S WESTERN AVE STE 102
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-1008
Practice Address - Country:US
Practice Address - Phone:323-641-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty