MEDICARE: FAMILY TREE HEALTH.INC

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1932920055
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY TREE HEALTH.INC

Provider Business Mailing Address
First Line	:	20627 GOLDEN SPRINGS DR STE 1J
Second Line	:
City	:	DIAMOND BAR
State	:	CA
Zip	:	91789-4815
Country	:	US
Telephone Number	:	909-903-0102
Fax Number	:

Provider Business Practice Location Address
First Line	:	20627 GOLDEN SPRINGS DR STE 1J
Second Line	:
City	:	DIAMOND BAR
State	:	CA
Zip	:	91789-4815
Country	:	US
Telephone Number	:	909-903-0102
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JIN HEE PARK
Credential	:	L.AC
Telephone Number	:	909-903-0102

Provider Enumeration Date	:	10/21/2024
Last Update Date	:	10/21/2024

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Directions to “FAMILY TREE HEALTH.INC ” Practice Location

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