Provider Demographics
NPI:1265922520
Name:LOMITA ACUPUNCTURE, INC.
Entity type:Organization
Organization Name:LOMITA ACUPUNCTURE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:MORTON
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-378-1323
Mailing Address - Street 1:1852 LOMITA BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:LOMITA
Mailing Address - State:CA
Mailing Address - Zip Code:90717-1902
Mailing Address - Country:US
Mailing Address - Phone:424-378-1323
Mailing Address - Fax:
Practice Address - Street 1:1852 LOMITA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LOMITA
Practice Address - State:CA
Practice Address - Zip Code:90717-1902
Practice Address - Country:US
Practice Address - Phone:424-378-1323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-12
Last Update Date:2018-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center