Provider Demographics
NPI:1306238365
Name:TENG'S ACUPUNCTURE MEDICINE,INC.
Entity type:Organization
Organization Name:TENG'S ACUPUNCTURE MEDICINE,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LEEKONG
Authorized Official - Middle Name:
Authorized Official - Last Name:TENG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:714-843-6465
Mailing Address - Street 1:9626 SMOKE TREE AVE
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-7260
Mailing Address - Country:US
Mailing Address - Phone:714-843-6465
Mailing Address - Fax:714-843-6468
Practice Address - Street 1:18821 DELAWARE ST
Practice Address - Street 2:SUITE 205
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-1926
Practice Address - Country:US
Practice Address - Phone:714-843-6465
Practice Address - Fax:714-843-6468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 15512171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty