Provider Demographics
NPI:1992545388
Name:AYA ACUPUNCTURE & HERBS INC #2
Entity type:Organization
Organization Name:AYA ACUPUNCTURE & HERBS INC #2
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JI EUN
Authorized Official - Middle Name:
Authorized Official - Last Name:MIN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:626-427-1779
Mailing Address - Street 1:415 N CRESCENT DR STE 235
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-6823
Mailing Address - Country:US
Mailing Address - Phone:626-427-1779
Mailing Address - Fax:626-466-3886
Practice Address - Street 1:415 N CRESCENT DR STE 235
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-6823
Practice Address - Country:US
Practice Address - Phone:626-427-1779
Practice Address - Fax:626-466-3886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-31
Last Update Date:2024-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty