Provider Demographics
NPI:1194567040
Name:ACUSANA ACUPUNCTURE INC
Entity type:Organization
Organization Name:ACUSANA ACUPUNCTURE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:
Authorized Official - First Name:SEONHO
Authorized Official - Middle Name:
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:LAC / DAOM
Authorized Official - Phone:714-530-3550
Mailing Address - Street 1:9828 GARDEN GROVE BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92844-1652
Mailing Address - Country:US
Mailing Address - Phone:714-530-3550
Mailing Address - Fax:714-530-3550
Practice Address - Street 1:9828 GARDEN GROVE BLVD STE 106
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92844-1652
Practice Address - Country:US
Practice Address - Phone:714-530-3550
Practice Address - Fax:714-530-3550
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACUSANA ACUPUNCTURE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty