Healthcare Provider Details

I. General information

NPI: 1639273030
Provider Name (Legal Business Name): MEI JUAN ZHOU LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 S ATLANTIC BLVD
MONTEREY PARK CA
91754-3816
US

IV. Provider business mailing address

508 S ATLANTIC BLVD
MONTEREY PARK CA
91754-3816
US

V. Phone/Fax

Practice location:
  • Phone: 626-458-0555
  • Fax: 626-458-9401
Mailing address:
  • Phone: 626-458-0555
  • Fax: 626-458-9401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC8495
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: