Provider Demographics
NPI:1891913794
Name:AMERICAN 3J INC
Entity Type:Organization
Organization Name:AMERICAN 3J INC
Other - Org Name:DRAGON MOON HEALTH STATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:HONG
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:MS OMD LAC
Authorized Official - Phone:310-828-6356
Mailing Address - Street 1:PO BOX 194
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90406
Mailing Address - Country:US
Mailing Address - Phone:310-828-6356
Mailing Address - Fax:310-449-0081
Practice Address - Street 1:2222 SANTA MONICA BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404
Practice Address - Country:US
Practice Address - Phone:310-828-6356
Practice Address - Fax:310-449-0081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8632261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service