Provider Demographics
NPI:1548073257
Name:ACUWAVE CLINIC INC.
Entity type:Organization
Organization Name:ACUWAVE CLINIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:YOO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-435-5714
Mailing Address - Street 1:553 S ST ANDREWS PL APT 106
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-4410
Mailing Address - Country:US
Mailing Address - Phone:213-435-5714
Mailing Address - Fax:
Practice Address - Street 1:4675 STEVENS CREEK BLVD STE 121
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-6763
Practice Address - Country:US
Practice Address - Phone:213-435-5714
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty