Provider Demographics
NPI:1841585056
Name:PARK'S ACUPUNCTURE CLINIC & HERBS
Entity Type:Organization
Organization Name:PARK'S ACUPUNCTURE CLINIC & HERBS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:SAEONG BIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:805-686-0805
Mailing Address - Street 1:650 ALAMO PINTADO RD STE 104
Mailing Address - Street 2:
Mailing Address - City:SOLVANG
Mailing Address - State:CA
Mailing Address - Zip Code:93463-2266
Mailing Address - Country:US
Mailing Address - Phone:805-686-0805
Mailing Address - Fax:805-728-7193
Practice Address - Street 1:650 ALAMO PINTADO RD STE 104
Practice Address - Street 2:
Practice Address - City:SOLVANG
Practice Address - State:CA
Practice Address - Zip Code:93463-2266
Practice Address - Country:US
Practice Address - Phone:805-686-0805
Practice Address - Fax:805-728-7193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-15
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7811171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty