Provider Demographics
NPI:1730770728
Name:WAVE ACUPUNCTURE & ORIENTAL MEDICINE INC
Entity type:Organization
Organization Name:WAVE ACUPUNCTURE & ORIENTAL MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEONG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-864-8280
Mailing Address - Street 1:4909 ISLANDS DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-1944
Mailing Address - Country:US
Mailing Address - Phone:661-864-8280
Mailing Address - Fax:
Practice Address - Street 1:7737 MEANY AVE STE B3
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-5267
Practice Address - Country:US
Practice Address - Phone:661-864-8280
Practice Address - Fax:800-881-5402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty