Provider Demographics
NPI:1831464494
Name:HOLISTIC ACUPUNCTURE INC
Entity Type:Organization
Organization Name:HOLISTIC ACUPUNCTURE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MR
Authorized Official - First Name:SANG HOON
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-913-0023
Mailing Address - Street 1:539 N GLENOAKS BLVD # 204A-1
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-3201
Mailing Address - Country:US
Mailing Address - Phone:323-913-0023
Mailing Address - Fax:323-913-0039
Practice Address - Street 1:539 N GLENOAKS BLVD # 204A-1
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-3201
Practice Address - Country:US
Practice Address - Phone:323-913-0023
Practice Address - Fax:323-913-0039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-15
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC13488171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty