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NPI 1528444668 · on the registry since 2015 · sole proprietor

Practice

Address: 369 N Fairfax Ave Ste 2
Los Angeles, CA 90036
Phone: (323) 963-5027
Fax: (323) 499-1274
Organisation at this address: Energetic Acupuncture Medical Group
La Clinic Of Medicine Genetics And Preventive Care
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy: 171100000X
171100000X
Licence states on file: CA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2026-06-24

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California