Provider Demographics
NPI:1760750699
Name:SUN ACUPUNCTURE & HEALING CENTER
Entity Type:Organization
Organization Name:SUN ACUPUNCTURE & HEALING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:KYUNGYEOL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:L,AC
Authorized Official - Phone:415-766-5678
Mailing Address - Street 1:1300 25TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-1563
Mailing Address - Country:US
Mailing Address - Phone:415-766-5678
Mailing Address - Fax:415-373-1708
Practice Address - Street 1:1300 25TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-1563
Practice Address - Country:US
Practice Address - Phone:415-766-5678
Practice Address - Fax:415-373-1708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11924171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty