Basic Information
| Provider Information | |||||||||
| NPI: | 1265783724 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SUN AND MOON ACUPUNCTURE,INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 758 E COLORADO BLVD | ||||||||
| Address2: | 201 | ||||||||
| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911012127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2132683007 | ||||||||
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| Practice Location | |||||||||
| Address1: | 758 E COLORADO BLVD | ||||||||
| Address2: | 201 | ||||||||
| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911012127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2132683007 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/24/2012 | ||||||||
| LastUpdateDate: | 09/24/2012 | ||||||||
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| AuthorizedOfficialLastName: | MOON | ||||||||
| AuthorizedOfficialFirstName: | JOO HYUN | ||||||||
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| AuthorizedOfficialTitleorPosition: | ACUPUNCTURIST | ||||||||
| AuthorizedOfficialTelephone: | 2132683007 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | L.AC., DAOM | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171100000X | AC11179 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Acupuncturist |
No ID Information.