Provider Demographics
NPI:1336919281
Name:LIFELINE ACU INC.
Entity Type:Organization
Organization Name:LIFELINE ACU INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HONG JOON
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-335-1752
Mailing Address - Street 1:4701 WHITNEY AVE
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-2953
Mailing Address - Country:US
Mailing Address - Phone:916-589-7020
Mailing Address - Fax:530-756-1450
Practice Address - Street 1:4701 WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-2953
Practice Address - Country:US
Practice Address - Phone:916-589-7020
Practice Address - Fax:530-756-1450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty