Provider Demographics
NPI:1053620468
Name:GRACE HEALING HAND ACUPUNCTURE INC
Entity type:Organization
Organization Name:GRACE HEALING HAND ACUPUNCTURE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDMOND
Authorized Official - Middle Name:HWAN
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:ACUPUNCTURIST
Authorized Official - Phone:818-395-4415
Mailing Address - Street 1:330 W AVENUE 26
Mailing Address - Street 2:#328
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-1478
Mailing Address - Country:US
Mailing Address - Phone:818-295-4415
Mailing Address - Fax:
Practice Address - Street 1:330 W AVENUE 26
Practice Address - Street 2:#328
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90031-1478
Practice Address - Country:US
Practice Address - Phone:818-295-4415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-03
Last Update Date:2010-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 12258174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty