Provider Demographics
NPI:1578980322
Name:SUN ACUPUNCTURE AND HERB CLINIC CORP
Entity Type:Organization
Organization Name:SUN ACUPUNCTURE AND HERB CLINIC CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:SUN
Authorized Official - Last Name:YEE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:714-228-1182
Mailing Address - Street 1:2271 W. MALVERN AVE
Mailing Address - Street 2:STE # 403
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92833
Mailing Address - Country:US
Mailing Address - Phone:714-228-1182
Mailing Address - Fax:714-871-4459
Practice Address - Street 1:1235 N. HARBOR BLVD
Practice Address - Street 2:STE # 111
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-1323
Practice Address - Country:US
Practice Address - Phone:714-228-1182
Practice Address - Fax:714-871-4459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-18
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11200171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty