Healthcare Provider Details

I. General information

NPI: 1568781102
Provider Name (Legal Business Name): BELLEVIE HEALTHCARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2010
Last Update Date: 06/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 S. GRAND AVE
DIAMOND BAR CA
91765-4119
US

IV. Provider business mailing address

12942 ELM TREE LN
CHINO HILLS CA
91709-1132
US

V. Phone/Fax

Practice location:
  • Phone: 714-726-1841
  • Fax: 909-248-0171
Mailing address:
  • Phone: 714-726-1841
  • Fax: 909-248-0171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-31398
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number13716
License Number StateCA

VIII. Authorized Official

Name: DR. JOANNA CHUNYEN LIN
Title or Position: PRESIDENT
Credential: D.C., L.AC.
Phone: 714-726-1841