Provider Demographics
NPI:1154720175
Name:JS ACUPUNCTURE SERVICE
Entity type:Organization
Organization Name:JS ACUPUNCTURE SERVICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:YOUNG HOON
Authorized Official - Middle Name:
Authorized Official - Last Name:CHA
Authorized Official - Suffix:
Authorized Official - Credentials:DAOM
Authorized Official - Phone:818-249-9329
Mailing Address - Street 1:3131 FOOTHILL BLVD STE M
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-4234
Mailing Address - Country:US
Mailing Address - Phone:818-249-9329
Mailing Address - Fax:
Practice Address - Street 1:3131 FOOTHILL BLVD STE M
Practice Address - Street 2:
Practice Address - City:LA CRESCENTA
Practice Address - State:CA
Practice Address - Zip Code:91214-4234
Practice Address - Country:US
Practice Address - Phone:818-249-9329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC13462261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain