Healthcare Provider Details

I. General information

NPI: 1316124365
Provider Name (Legal Business Name): G M HEALTH CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2008
Last Update Date: 02/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1008 A E GARVEY AVENUE
MONTEREY PARK CA
91755
US

IV. Provider business mailing address

1008 A E GARVEY AVENUE
MONTEREY PARK CA
91755
US

V. Phone/Fax

Practice location:
  • Phone: 626-288-6339
  • Fax: 626-288-6339
Mailing address:
  • Phone: 626-288-6339
  • Fax: 626-288-6339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC0031770
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberCA1179
License Number StateCA

VIII. Authorized Official

Name: ZHI MIAN ZHOU
Title or Position: ACUPUNCTURE DR OWNER
Credential: CERTIFIED ACUPUNCTUR
Phone: 626-288-6339