Healthcare Provider Details
I. General information
NPI: 1871925693
Provider Name (Legal Business Name): LA ALTERNATIVE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/02/2013
Last Update Date: 08/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6010 WILSHIRE BLVD SUITE 301
LOS ANGELES CA
90036-3615
US
IV. Provider business mailing address
6010 WILSHIRE BLVD. SUITE 301
LOS ANGELES CA
90036-3625
US
V. Phone/Fax
- Phone: 323-937-7889
- Fax:
- Phone: 323-937-7889
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
HONGMEI
J.
LI
Title or Position: CEO
Credential: O.M.D., L.AC
Phone: 818-606-7585