Provider Demographics
NPI:1366897050
Name:BLESS ACUPUNCTURE MEDICAL GROUP INC.
Entity type:Organization
Organization Name:BLESS ACUPUNCTURE MEDICAL GROUP INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OMD, ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:HYE EUN
Authorized Official - Middle Name:
Authorized Official - Last Name:KWON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-786-5372
Mailing Address - Street 1:7567 AMADOR VALLEY BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-2442
Mailing Address - Country:US
Mailing Address - Phone:925-828-7575
Mailing Address - Fax:925-828-7574
Practice Address - Street 1:7567 AMADOR VALLEY BLVD STE 105
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-2442
Practice Address - Country:US
Practice Address - Phone:925-828-7575
Practice Address - Fax:925-828-7574
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BLESS ACUPUNCTURE MEDICAL GROUP INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-04-29
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC9979261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service