Provider Demographics
NPI:1952014326
Name:PANOPTION.LLC
Entity Type:Organization
Organization Name:PANOPTION.LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF ORIENTAL MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:SAHNGJOON
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:OMD
Authorized Official - Phone:725-272-7250
Mailing Address - Street 1:4680 S EASTERN AVE STE E
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-6192
Mailing Address - Country:US
Mailing Address - Phone:725-272-7250
Mailing Address - Fax:
Practice Address - Street 1:4680 S EASTERN AVE STE E
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6192
Practice Address - Country:US
Practice Address - Phone:725-272-7250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-02
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2066OtherACUPUNCTURE