Organization
LIFE ACUMED SPA
Active
Organization
LIFE ACUMED SPA
Active
Parent organization
LIFE ACUMED SPA INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFE ACUMED SPA INC.
Authorized official
DR. LISA JEONG DAOM (PRESIDENT)
(650) 458-3391
Entity
Organization
Contact information
Practice address
146 W 25TH AVE., SAN MATEO, CA 94403-2208
(650) 458-3391
Mailing address
146 W 25TH AVE, SAN MATEO, CA 94403-2208
(650) 458-3391
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46-2930319
NPI
CA
Enumeration date
11/26/2018
Last updated
11/26/2018
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