Provider Demographics
NPI:1770152449
Name:ACUBALANCE CLINIC
Entity type:Organization
Organization Name:ACUBALANCE CLINIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HARRISON
Authorized Official - Middle Name:JOUNGKU
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-902-8787
Mailing Address - Street 1:1201 S BEACH BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-9700
Mailing Address - Country:US
Mailing Address - Phone:562-902-1010
Mailing Address - Fax:800-650-9114
Practice Address - Street 1:1201 S BEACH BLVD STE 102
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-9700
Practice Address - Country:US
Practice Address - Phone:562-902-1010
Practice Address - Fax:800-650-9114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-17
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty