Provider Demographics
NPI:1659788099
Name:HERBIN INC
Entity Type:Organization
Organization Name:HERBIN INC
Other - Org Name:HERBIN ACUPUNCTURE & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LARA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLJONEN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:619-564-8308
Mailing Address - Street 1:2801 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-6207
Mailing Address - Country:US
Mailing Address - Phone:619-564-8308
Mailing Address - Fax:
Practice Address - Street 1:2801 4TH AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-6207
Practice Address - Country:US
Practice Address - Phone:619-564-8308
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-17
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No172M00000XOther Service ProvidersMechanotherapistGroup - Multi-Specialty