Provider Demographics
NPI:1295857316
Name:TOTAL ACUPUNCTURE & WELLNESS CENTER
Entity Type:Organization
Organization Name:TOTAL ACUPUNCTURE & WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:K
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:LIC AC
Authorized Official - Phone:310-996-7778
Mailing Address - Street 1:11353 SANTA MONICA BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-3151
Mailing Address - Country:US
Mailing Address - Phone:310-996-7778
Mailing Address - Fax:310-996-7773
Practice Address - Street 1:11353 SANTA MONICA BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-3151
Practice Address - Country:US
Practice Address - Phone:310-996-7778
Practice Address - Fax:310-996-7773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty