Provider Demographics
NPI:1487935466
Name:DAN B ACUPUNCTURE INC
Entity type:Organization
Organization Name:DAN B ACUPUNCTURE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:JINWOO
Authorized Official - Middle Name:
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:714-366-3062
Mailing Address - Street 1:12792 VALLEY VIEW ST STE D
Mailing Address - Street 2:12792 VALLEY VIEW ST STE D
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92845-2509
Mailing Address - Country:US
Mailing Address - Phone:714-366-3062
Mailing Address - Fax:714-898-2589
Practice Address - Street 1:12792 VALLEY VIEW ST STE D
Practice Address - Street 2:12792 VALLEY VIEW ST STE D
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92845-2509
Practice Address - Country:US
Practice Address - Phone:714-366-3062
Practice Address - Fax:714-898-2589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-02
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12466261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center