Provider Demographics
NPI:1831470293
Name:SUN WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:SUN WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:L. AC. / MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHAE
Authorized Official - Middle Name:HO
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-444-0472
Mailing Address - Street 1:1560 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906-5101
Mailing Address - Country:US
Mailing Address - Phone:831-444-0472
Mailing Address - Fax:831-444-0472
Practice Address - Street 1:1560 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-5101
Practice Address - Country:US
Practice Address - Phone:831-444-0472
Practice Address - Fax:831-444-0472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 14193171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty