Healthcare Provider Details

I. General information

NPI: 1760138812
Provider Name (Legal Business Name): CLINIC NATURAE NATUROPATHIC PROFESSIONAL CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2022
Last Update Date: 02/28/2022
Certification Date: 02/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10850 WILSHIRE BLVD STE 240
LOS ANGELES CA
90024-4308
US

IV. Provider business mailing address

10701 WILSHIRE BLVD APT 1106
LOS ANGELES CA
90024-4437
US

V. Phone/Fax

Practice location:
  • Phone: 424-330-6683
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: DR. KAI-YUN CHENG
Title or Position: OWNER
Credential: ND, LAC
Phone: 424-330-6683