Provider Demographics
NPI:1689043267
Name:UNITY OF LIFE ACUPUNCTURE
Entity Type:Organization
Organization Name:UNITY OF LIFE ACUPUNCTURE
Other - Org Name:HAN ACUPUNCTURE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOONG
Authorized Official - Middle Name:G
Authorized Official - Last Name:HAN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:909-797-9020
Mailing Address - Street 1:32387 YUCAIPA BLVD STE F
Mailing Address - Street 2:
Mailing Address - City:YUCAIPA
Mailing Address - State:CA
Mailing Address - Zip Code:92399-1886
Mailing Address - Country:US
Mailing Address - Phone:909-797-9020
Mailing Address - Fax:
Practice Address - Street 1:32387 YUCAIPA BLVD STE F
Practice Address - Street 2:
Practice Address - City:YUCAIPA
Practice Address - State:CA
Practice Address - Zip Code:92399-1886
Practice Address - Country:US
Practice Address - Phone:909-797-9020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-24
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11976171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty