Acucenter Of La, Inc | |
4465 Wilshire Blvd Ste 303, Los Angeles, CA 90010-3716 | |
(323) 936-4000 | |
(323) 936-4001 |
Full Name | Acucenter Of La, Inc |
---|---|
Type | Facility |
Speciality | Chiropractor |
Location | 4465 Wilshire Blvd Ste 303, Los Angeles, California |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1295140929 | NPI | - | NPPES |
AC9809 | Medicaid | CA | |
DC32983 | Medicaid | CA | |
AC8688 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | DC32983 (California) | Primary |
171100000X | Acupuncturist | AC8688 (California) | Secondary |
171100000X | Acupuncturist | AC9809 (California) | Secondary |
Provider Name | Bongkyun Francisco Suh |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1912937442 PECOS PAC ID: 3870719883 Enrollment ID: I20140729000714 |
Mailing Address | Practice Location Address |
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Acucenter Of La, Inc 4465 Wilshire Blvd Ste 303, Los Angeles, CA 90010-3716 Ph: (323) 936-4000 | Acucenter Of La, Inc 4465 Wilshire Blvd Ste 303, Los Angeles, CA 90010-3716 Ph: (323) 936-4000 |
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