Healthcare Provider Details
I. General information
NPI: 1043691900
Provider Name (Legal Business Name): TOTALCARE ONE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/16/2015
Last Update Date: 06/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
318 N GARFIELD AVE STE A
MONTEREY PARK CA
91754-1707
US
IV. Provider business mailing address
318 N GARFIELD AVE STE A
MONTEREY PARK CA
91754-1707
US
V. Phone/Fax
- Phone: 626-280-2818
- Fax: 626-280-2848
- Phone: 626-280-2818
- Fax: 626-280-2848
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | DC31657 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | AC15587 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
WON
W
PARK
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 626-280-2818