Provider Demographics
NPI:1992475495
Name:JO, IMHEE (LAC)
Entity type:Individual
Prefix:MISS
First Name:IMHEE
Middle Name:
Last Name:JO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4465 WILSHIRE BLVD # 101-C
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-3704
Mailing Address - Country:US
Mailing Address - Phone:213-264-2513
Mailing Address - Fax:
Practice Address - Street 1:4465 WILSHIRE BLVD # 101-C
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-3704
Practice Address - Country:US
Practice Address - Phone:213-264-2513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-15
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19257171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist