Healthcare Provider Details

I. General information

NPI: 1831609239
Provider Name (Legal Business Name): GUAN MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2017
Last Update Date: 10/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3460 OCEAN VIEW BLVD STE A
GLENDALE CA
91208-3304
US

IV. Provider business mailing address

3460 OCEAN VIEW BLVD STE A
GLENDALE CA
91208-3304
US

V. Phone/Fax

Practice location:
  • Phone: 818-957-2289
  • Fax:
Mailing address:
  • Phone: 818-957-2289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC12509
License Number StateCA

VIII. Authorized Official

Name: ZHEN GUAN
Title or Position: OWNER
Credential:
Phone: 818-957-2289