Organization
FATA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SOON PARK (PRESIDENT)
(661) 633-9673
Entity
Organization
Contact information
Practice address
2004 BRUNDAGE LANE, BAKERSFIELD, CA 93304
(661) 663-9673
Mailing address
2004 BRUNDAGE LANE, BAKERSFIELD, CA 93304
(661) 663-9673
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC12047
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AC12047
ACUPUNCTURE
CA
Enumeration date
01/06/2010
Last updated
01/06/2010
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