Geunjae Clinic LLC.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

0121000725 Issued in VA

Legal business name

GEUNJAE CLINIC LLC.

Practice address

14641 Lee Hwy, Ste D-6
Centreville, VA 20121-2112

Phone

(703) 625-7116

NPI assigned

Oct 27, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Wang Young Yoo, .L.AC. DIPL.OMNPI 1710388780

Title

Director

Phone

(703) 625-7116

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wang Young Yoo, DIPL. OM, L.AC, PHD

  • Acupuncturist
  • Centreville, VA
  • NPI 1710388780
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1477526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477526400000",
    "number": "1952853798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14641 LEE HWY, D-6",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201212112",
            "telephone_number": "703-625-7116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14641 LEE HWY, STE D-6",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201212112",
            "telephone_number": "703-625-7116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEUNJAE CLINIC LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-27",
        "last_updated": "2016-10-27",
        "status": "A",
        "authorized_official_last_name": "YOO",
        "authorized_official_first_name": "WANG",
        "authorized_official_middle_name": "YOUNG",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "703-625-7116",
        "authorized_official_credential": ".L.AC. DIPL.OM"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "VA",
            "license": "0121000725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L.AC",
            "identifier": "0121000725",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACUPUNCTURIST",
            "identifier": "0121000725",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maureen Fulkerson, MED, LPC
• Anjali Garg, M.D.
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• Sharon Gehrman, OT
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• Ghanbari & Koshki, DDS PC
• Mohsen Ghanbari, D.D.S.
• Giant of Maryland LLC
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• Kelly Erin Gibson

• Acupuncturist in Centreville, VA
• Providers in Centreville, VA by specialty
• Acupuncturist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.