Provider Demographics
NPI:1528522364
Name:MERIDIAN ACUPUNCTURE AND HERBAL MEDICINE, INC.
Entity type:Organization
Organization Name:MERIDIAN ACUPUNCTURE AND HERBAL MEDICINE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GAYLIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HEIN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:714-642-4661
Mailing Address - Street 1:425 OLD NEWPORT BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-4251
Mailing Address - Country:US
Mailing Address - Phone:714-642-4661
Mailing Address - Fax:
Practice Address - Street 1:425 OLD NEWPORT BLVD STE D
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-4251
Practice Address - Country:US
Practice Address - Phone:714-642-4661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-25
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty