MEDICARE: ALTERNATIVE WELLNESS CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AC7765	CA

General Provider Information

NPI Number	:	1154579779
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALTERNATIVE WELLNESS CENTER

Provider Business Mailing Address
First Line	:	3720 KATELLA AVE
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-3102
Country	:	US
Telephone Number	:	562-430-8889
Fax Number	:	562-430-8518

Provider Business Practice Location Address
First Line	:	3720 KATELLA AVE
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-3102
Country	:	US
Telephone Number	:	562-430-8889
Fax Number	:	562-430-8518

Authorized Official
Title or Position	:	CEO
Name	:	DR. JEAN C FU
Credential	:	L.AC., QME., PH.D.
Telephone Number	:	562-430-8889

Provider Enumeration Date	:	09/08/2008
Last Update Date	:	03/06/2009

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Directions to “ALTERNATIVE WELLNESS CENTER ” Practice Location

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