Provider Demographics
NPI:1689926024
Name:JAEIN ACUPUNCTURE & HERBAL MEDICINE, INC.
Entity Type:Organization
Organization Name:JAEIN ACUPUNCTURE & HERBAL MEDICINE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:WON HEE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-732-1035
Mailing Address - Street 1:4847 AQUAMARINE WAY
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-3772
Mailing Address - Country:US
Mailing Address - Phone:714-732-1035
Mailing Address - Fax:714-738-5885
Practice Address - Street 1:12235 BEACH BLVD STE 115A
Practice Address - Street 2:
Practice Address - City:STANTON
Practice Address - State:CA
Practice Address - Zip Code:90680-3942
Practice Address - Country:US
Practice Address - Phone:714-732-1035
Practice Address - Fax:714-738-5885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-09
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC13960171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty