Provider Demographics
NPI:1538694013
Name:KOPRO HEALTH
Entity Type:Organization
Organization Name:KOPRO HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:GIN-JU
Authorized Official - Last Name:KO
Authorized Official - Suffix:
Authorized Official - Credentials:MHS, LAC
Authorized Official - Phone:949-436-8521
Mailing Address - Street 1:2950 N GLASSELL ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92865-1078
Mailing Address - Country:US
Mailing Address - Phone:949-436-8521
Mailing Address - Fax:
Practice Address - Street 1:2950 N GLASSELL ST
Practice Address - Street 2:SUITE B
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92865-1078
Practice Address - Country:US
Practice Address - Phone:949-436-8521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-21
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC17316171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty