Provider Demographics
NPI:1316534308
Name:SAEBOM HERBS & ACUPUNCTURE CLINIC
Entity type:Organization
Organization Name:SAEBOM HERBS & ACUPUNCTURE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST / OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BO
Authorized Official - Middle Name:WAN
Authorized Official - Last Name:SUH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-377-5112
Mailing Address - Street 1:7800 COMMONWEALTH AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-2496
Mailing Address - Country:US
Mailing Address - Phone:714-337-3068
Mailing Address - Fax:714-509-1783
Practice Address - Street 1:7800 COMMONWEALTH AVE STE 203
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-2496
Practice Address - Country:US
Practice Address - Phone:714-337-3068
Practice Address - Fax:714-509-1783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-24
Last Update Date:2020-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty