Provider Demographics
NPI:1629834510
Name:NATURAL F&B LLC (DBA: INTEGRATED HEALTHCARE CLINIC)
Entity Type:Organization
Organization Name:NATURAL F&B LLC (DBA: INTEGRATED HEALTHCARE CLINIC)
Other - Org Name:GANGNAM INTEGRATED HEALTHCARE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:YONG UK
Authorized Official - Middle Name:
Authorized Official - Last Name:PYUN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, OMD
Authorized Official - Phone:703-409-6975
Mailing Address - Street 1:13890 BRADDOCK RD STE 304C
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20121-2438
Mailing Address - Country:US
Mailing Address - Phone:703-409-6975
Mailing Address - Fax:
Practice Address - Street 1:13890 BRADDOCK RD STE 304C
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20121-2438
Practice Address - Country:US
Practice Address - Phone:703-409-6975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-27
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty