Provider Demographics
NPI:1952694911
Name:WMP&ACUMILLE
Entity Type:Organization
Organization Name:WMP&ACUMILLE
Other - Org Name:LAKE ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:HYUNSOOK
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-512-8282
Mailing Address - Street 1:4482 BARRANCA PKWY STE 244
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4770
Mailing Address - Country:US
Mailing Address - Phone:949-551-8282
Mailing Address - Fax:949-313-0969
Practice Address - Street 1:4482 BARRANCA PKWY STE 244
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4770
Practice Address - Country:US
Practice Address - Phone:949-551-8282
Practice Address - Fax:949-313-0969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12700171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty