Provider Demographics
NPI:1568906170
Name:LUKE ACUPUNCTURE, INC.
Entity Type:Organization
Organization Name:LUKE ACUPUNCTURE, INC.
Other - Org Name:JOY ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SUNGMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:YEE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:714-820-3272
Mailing Address - Street 1:401 N BROOKHURST ST
Mailing Address - Street 2:SUITE #106
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-5636
Mailing Address - Country:US
Mailing Address - Phone:714-820-3272
Mailing Address - Fax:
Practice Address - Street 1:401 N BROOKHURST ST
Practice Address - Street 2:SUITE #106
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-5636
Practice Address - Country:US
Practice Address - Phone:714-820-3272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-16
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALAC15661302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization