Provider Demographics
NPI:1386029783
Name:ACUPUNCTURE ONE CENTER, INC
Entity Type:Organization
Organization Name:ACUPUNCTURE ONE CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KYUNG
Authorized Official - Middle Name:H
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:323-470-3494
Mailing Address - Street 1:31348 VIA COLINAS
Mailing Address - Street 2:SUITE 105
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-3913
Mailing Address - Country:US
Mailing Address - Phone:818-575-9096
Mailing Address - Fax:818-575-9098
Practice Address - Street 1:31348 VIA COLINAS
Practice Address - Street 2:SUITE 105
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-3913
Practice Address - Country:US
Practice Address - Phone:818-575-9096
Practice Address - Fax:818-575-9098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-27
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12286171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty