Healthcare Provider Details

I. General information

NPI: 1245784537
Provider Name (Legal Business Name): BODY BALANCE HOLISTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2016
Last Update Date: 01/16/2026
Certification Date: 01/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23517 MAIN ST STE 103
CARSON CA
90745-5234
US

IV. Provider business mailing address

23517 MAIN ST STE 103
CARSON CA
90745-5234
US

V. Phone/Fax

Practice location:
  • Phone: 818-940-1168
  • Fax:
Mailing address:
  • Phone: 818-940-1168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number StateCA

VIII. Authorized Official

Name: MR. JOHN K CHEUNG
Title or Position: ACUPUNCTURIST/PRESIDENT
Credential: L.AC
Phone: 626-780-3015