Provider Demographics
NPI:1710453808
Name:YOUNG JI ACUPUNCTURE CLINIC
Entity Type:Organization
Organization Name:YOUNG JI ACUPUNCTURE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YOUNG
Authorized Official - Middle Name:AE
Authorized Official - Last Name:JI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:703-505-7387
Mailing Address - Street 1:12921 OLD COLUMBIA PIKE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-5225
Mailing Address - Country:US
Mailing Address - Phone:703-505-7387
Mailing Address - Fax:
Practice Address - Street 1:3459 SAINT JOHNS LN STE 9
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-4026
Practice Address - Country:US
Practice Address - Phone:703-505-7387
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-16
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain