Provider Demographics
NPI:1063103091
Name:CHINESE MEDICAL CLINIC, INC
Entity type:Organization
Organization Name:CHINESE MEDICAL CLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAIBAO
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-707-0034
Mailing Address - Street 1:9100 BELVEDERE RD STE 109-110
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-3607
Mailing Address - Country:US
Mailing Address - Phone:561-791-9970
Mailing Address - Fax:
Practice Address - Street 1:9100 BELVEDERE RD STE 109-110
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-3607
Practice Address - Country:US
Practice Address - Phone:561-791-9970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-19
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty