Provider Demographics
NPI:1245529411
Name:OIKOS ACUPUNCTURE CLINIC
Entity type:Organization
Organization Name:OIKOS ACUPUNCTURE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAEHOON
Authorized Official - Middle Name:
Authorized Official - Last Name:MOON
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:510-639-7879
Mailing Address - Street 1:7850 EDGEWATER DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94621-2033
Mailing Address - Country:US
Mailing Address - Phone:510-639-7879
Mailing Address - Fax:510-639-7810
Practice Address - Street 1:7850 EDGEWATER DR
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94621-2033
Practice Address - Country:US
Practice Address - Phone:510-639-7879
Practice Address - Fax:510-639-7810
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OIKOS UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-28
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 13652171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty