Provider Demographics
NPI:1154554673
Name:ACME CONSULTATIVE EVALUATION MEDICAL CENTER
Entity type:Organization
Organization Name:ACME CONSULTATIVE EVALUATION MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-889-7255
Mailing Address - Street 1:14482 BEACH BLVD
Mailing Address - Street 2:# R
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5341
Mailing Address - Country:US
Mailing Address - Phone:714-889-7255
Mailing Address - Fax:
Practice Address - Street 1:14482 BEACH BLVD
Practice Address - Street 2:# R
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5341
Practice Address - Country:US
Practice Address - Phone:714-889-7255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-01
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG58330172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty