Provider Demographics
NPI:1366938896
Name:ORIENTAL HOLISTIC ACUPUNCTURE HEALTHE CENTER INC
Entity type:Organization
Organization Name:ORIENTAL HOLISTIC ACUPUNCTURE HEALTHE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:626-905-1833
Mailing Address - Street 1:1414 S. AZUSA AVE.
Mailing Address - Street 2:STE B-5
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791
Mailing Address - Country:US
Mailing Address - Phone:626-905-1833
Mailing Address - Fax:
Practice Address - Street 1:1414 S. AZUSA AVE.
Practice Address - Street 2:STE B-5
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91791
Practice Address - Country:US
Practice Address - Phone:626-905-1833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16402171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty