Healthcare Provider Details

I. General information

NPI: 1811129091
Provider Name (Legal Business Name): ASIAN PACIFIC HEALTH CARE VENTURE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2009
Last Update Date: 04/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 UNION PL
LOS ANGELES CA
90026-5715
US

IV. Provider business mailing address

4216 FOUNTAIN AVE
LOS ANGELES CA
90029-2256
US

V. Phone/Fax

Practice location:
  • Phone: 323-644-3880
  • Fax: 323-660-0935
Mailing address:
  • Phone: 323-644-3880
  • Fax: 323-660-0935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: KAZUE SHIBATA
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 323-644-3880