Provider Demographics
NPI:1366948986
Name:HOPPER ACUPUNCTURE AND HERBS INC.
Entity type:Organization
Organization Name:HOPPER ACUPUNCTURE AND HERBS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:KAYLIE
Authorized Official - Middle Name:DOROTHY
Authorized Official - Last Name:HOPPER
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:760-450-7314
Mailing Address - Street 1:201 N AVENUE 55 APT 202
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-4168
Mailing Address - Country:US
Mailing Address - Phone:750-450-7314
Mailing Address - Fax:
Practice Address - Street 1:5812 N FIGUEROA ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-4228
Practice Address - Country:US
Practice Address - Phone:760-450-7314
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16802171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty