Provider Demographics
NPI:1760706279
Name:DUNAMIS ACUPUNCTURE & HERB CLINIC, INC
Entity Type:Organization
Organization Name:DUNAMIS ACUPUNCTURE & HERB CLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MR
Authorized Official - First Name:SEJIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:714-578-0580
Mailing Address - Street 1:1418 S EUCLID ST
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-3135
Mailing Address - Country:US
Mailing Address - Phone:714-578-0580
Mailing Address - Fax:714-578-0585
Practice Address - Street 1:1418 S EUCLID ST
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-3135
Practice Address - Country:US
Practice Address - Phone:714-578-0580
Practice Address - Fax:714-578-0585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-26
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11685171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty