Provider Demographics
NPI: | 1134876170 |
---|---|
Name: | YURIM ACUPUNCTURE INC |
Entity type: | Organization |
Organization Name: | YURIM ACUPUNCTURE INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | WAN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | KIM |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LAC |
Authorized Official - Phone: | 408-645-8232 |
Mailing Address - Street 1: | 100 SARATOGA AVE STE 110 |
Mailing Address - Street 2: | |
Mailing Address - City: | SANTA CLARA |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 95051-7337 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 408-645-8232 |
Mailing Address - Fax: | 408-217-2410 |
Practice Address - Street 1: | 100 SARATOGA AVE STE 110 |
Practice Address - Street 2: | |
Practice Address - City: | SANTA CLARA |
Practice Address - State: | CA |
Practice Address - Zip Code: | 95051-7337 |
Practice Address - Country: | US |
Practice Address - Phone: | 408-645-8232 |
Practice Address - Fax: | 408-217-2410 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2022-03-09 |
Last Update Date: | 2024-08-19 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 171100000X | Other Service Providers | Acupuncturist | Group - Multi-Specialty | |
No | 111N00000X | Chiropractic Providers | Chiropractor | Group - Multi-Specialty |