Provider Demographics
NPI:1659022606
Name:SUYEON ACUPUNCTURE CLINIC INC
Entity Type:Organization
Organization Name:SUYEON ACUPUNCTURE CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INDIVIDUAL AGENT
Authorized Official - Prefix:
Authorized Official - First Name:SU YEON
Authorized Official - Middle Name:
Authorized Official - Last Name:SON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-595-1586
Mailing Address - Street 1:3207 S BREA CANYON RD STE B
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-3458
Mailing Address - Country:US
Mailing Address - Phone:909-595-1586
Mailing Address - Fax:909-595-1546
Practice Address - Street 1:3207 S BREA CANYON RD STE B
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-3458
Practice Address - Country:US
Practice Address - Phone:909-595-1586
Practice Address - Fax:909-595-1546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty