Individual
HOC DO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7138 SHOUP AVE, STE B4, CANOGA PARK, CA 91307-2383
(818) 887-1656
(818) 887-1765
Mailing address
7138 SHOUP AVE, SUITE B4, CANOGA PARK, CA 91307-2383
(818) 887-1656
(818) 887-1765
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC7474
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AC0074740
—
CA
Enumeration date
09/29/2005
Last updated
01/07/2009
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