Healthcare Provider Details
I. General information
NPI: 1043393556
Provider Name (Legal Business Name): BEVERLY HILLS ACUPUNCTURE & HERBOLOGY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
450 N BEDFORD DR STE 213A
BEVERLY HILLS CA
90210-4306
US
IV. Provider business mailing address
450 N BEDFORD DR STE 213A
BEVERLY HILLS CA
90210-4306
US
V. Phone/Fax
- Phone: 310-276-8898
- Fax:
- Phone: 310-276-8898
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | AC7138, AC7088 |
| License Number State | CA |
VIII. Authorized Official
Name:
CHUNYI
QIAN
Title or Position: CEO
Credential: ACUPUNCTURIST
Phone: 310-276-8898