Healthcare Provider Details

I. General information

NPI: 1750157517
Provider Name (Legal Business Name): HWA ANN ACUPUNCTURE & HERBS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2023
Last Update Date: 12/12/2023
Certification Date: 12/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1433 W MERCED AVE STE 309
WEST COVINA CA
91790-3402
US

IV. Provider business mailing address

1433 W MERCED AVE STE 309
WEST COVINA CA
91790-3402
US

V. Phone/Fax

Practice location:
  • Phone: 626-513-8029
  • Fax: 626-513-2937
Mailing address:
  • Phone: 626-513-8029
  • Fax: 626-513-2937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LIANG WEN CHEN
Title or Position: DIRECTOR
Credential:
Phone: 714-909-4525