Healthcare Provider Details

I. General information

NPI: 1407993405
Provider Name (Legal Business Name): KAN-SAI HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 04/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 E 2ND ST 116
LOS ANGELES CA
90012-4250
US

IV. Provider business mailing address

319 E 2ND ST 116
LOS ANGELES CA
90012-4250
US

V. Phone/Fax

Practice location:
  • Phone: 213-680-4954
  • Fax: 213-680-9215
Mailing address:
  • Phone: 213-680-4954
  • Fax: 888-246-3934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC24418
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC4010
License Number StateCA

VIII. Authorized Official

Name: GILLIAN HSUEH
Title or Position: MANAGER
Credential: D.C., AC
Phone: 213-680-4954