Provider Demographics
NPI:1548996465
Name:INNER BEAUTY ACU CLINIC
Entity type:Organization
Organization Name:INNER BEAUTY ACU CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:DR
Authorized Official - First Name:SU MI
Authorized Official - Middle Name:
Authorized Official - Last Name:WON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-527-8348
Mailing Address - Street 1:12711 NEWPORT AVE STE A
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-8008
Mailing Address - Country:US
Mailing Address - Phone:949-527-8348
Mailing Address - Fax:
Practice Address - Street 1:12711 NEWPORT AVE STE A
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-8008
Practice Address - Country:US
Practice Address - Phone:949-527-8348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty