Provider Demographics
NPI:1477941185
Name:SEVEN OAKS WELLNESS CENTER
Entity Type:Organization
Organization Name:SEVEN OAKS WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIN KYEONG
Authorized Official - Middle Name:
Authorized Official - Last Name:KWON
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:805-925-2395
Mailing Address - Street 1:940 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-5331
Mailing Address - Country:US
Mailing Address - Phone:805-925-2395
Mailing Address - Fax:805-666-2724
Practice Address - Street 1:940 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-5331
Practice Address - Country:US
Practice Address - Phone:805-925-2395
Practice Address - Fax:805-666-2724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-05
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC10209171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty