Provider Demographics
NPI:1508547308
Name:RIVERNORTH ACUPUNCTURE INC
Entity Type:Organization
Organization Name:RIVERNORTH ACUPUNCTURE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, CFO, SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:HYOSU
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:909-642-4936
Mailing Address - Street 1:404 S PROSPECTORS RD STE B
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-1617
Mailing Address - Country:US
Mailing Address - Phone:909-642-4936
Mailing Address - Fax:909-992-3747
Practice Address - Street 1:404 S PROSPECTORS RD STE B
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-1617
Practice Address - Country:US
Practice Address - Phone:909-642-4936
Practice Address - Fax:909-992-3747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty