Provider Demographics
NPI:1861727265
Name:SERENITY ACUPUNCTURE CENTER
Entity type:Organization
Organization Name:SERENITY ACUPUNCTURE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:YI
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, PHARM D
Authorized Official - Phone:310-257-1725
Mailing Address - Street 1:3525 LOMITA BLVD
Mailing Address - Street 2:#101
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5024
Mailing Address - Country:US
Mailing Address - Phone:310-257-1725
Mailing Address - Fax:
Practice Address - Street 1:3525 LOMITA BLVD
Practice Address - Street 2:#101
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5024
Practice Address - Country:US
Practice Address - Phone:310-257-1725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEST AMERICA UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 13075171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty