| NPI | 1316349012 |
|---|---|
| Doing Business As | NO |
| Entity Type | Organization |
| Authorized Contact | DONG WOO PARK Acupuncturist 213-700-9314 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: CA ac8057) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: CA AC8057) |
| Enumeration Date | 2014-09-24 |
| Last Update Date | 2014-09-24 |