Provider Demographics
NPI:1366029399
Name:THANKSGIVING ACUHEALING CENTER INC.
Entity Type:Organization
Organization Name:THANKSGIVING ACUHEALING CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:BAKYOUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:SOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-503-6208
Mailing Address - Street 1:2701 E CHAPMAN AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92831-3750
Mailing Address - Country:US
Mailing Address - Phone:213-503-6208
Mailing Address - Fax:714-515-3049
Practice Address - Street 1:2701 E CHAPMAN AVE STE 109
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-3750
Practice Address - Country:US
Practice Address - Phone:213-503-6208
Practice Address - Fax:714-515-3049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC16556OtherCALIFORNIA ACUPUCNCTURE BOARD