Provider Demographics
NPI:1982993903
Name:BLISS ACUPUNCTURE CLINIC INC
Entity Type:Organization
Organization Name:BLISS ACUPUNCTURE CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JONG-HWA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-925-3709
Mailing Address - Street 1:3500 BARRANCA PKWY STE 330
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-8288
Mailing Address - Country:US
Mailing Address - Phone:949-654-1500
Mailing Address - Fax:949-654-1551
Practice Address - Street 1:3500 BARRANCA PKWY STE 330
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-8288
Practice Address - Country:US
Practice Address - Phone:949-654-1500
Practice Address - Fax:949-654-1551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-30
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 13005171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty