Provider Demographics
NPI:1790196913
Name:ONNURI-3004,INC.
Entity Type:Organization
Organization Name:ONNURI-3004,INC.
Other - Org Name:3 ANGELS HEALTH AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ ACUPUNCTURIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EUN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SONG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC PHD
Authorized Official - Phone:310-859-7696
Mailing Address - Street 1:250 N ROBERTSON BLVD STE 516
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-1789
Mailing Address - Country:US
Mailing Address - Phone:310-859-7696
Mailing Address - Fax:310-859-7699
Practice Address - Street 1:250 N ROBERTSON BLVD STE 516
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1789
Practice Address - Country:US
Practice Address - Phone:310-859-7696
Practice Address - Fax:310-859-7699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-09
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8225171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty