Healthcare Provider Details

I. General information

NPI: 1538323902
Provider Name (Legal Business Name): TCH ACUPUNCTURE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2008
Last Update Date: 07/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2130 HUNTINGTON DR #214
SOUTH PASADENA CA
91030-4964
US

IV. Provider business mailing address

12723 CHARLWOOD ST
CERRITOS CA
90703-6051
US

V. Phone/Fax

Practice location:
  • Phone: 626-617-3193
  • Fax:
Mailing address:
  • Phone: 562-916-7960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number3123182
License Number StateCA

VIII. Authorized Official

Name: PAO-CHIANG LU
Title or Position: CHAIRMEN
Credential:
Phone: 562-916-7960