Healthcare Provider Details

I. General information

NPI: 1760094239
Provider Name (Legal Business Name): DC CLINIC - ACUPUNCTURE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2020
Last Update Date: 02/12/2021
Certification Date: 02/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10801 NATIONAL BLVD STE 607
LOS ANGELES CA
90064-4126
US

IV. Provider business mailing address

514 S HARBOR BLVD
SANTA ANA CA
92704-1326
US

V. Phone/Fax

Practice location:
  • Phone: 323-256-8818
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: DR. DOUGLASS CHENG
Title or Position: CEO
Credential: DC, LAC
Phone: 323-256-8818