Healthcare Provider Details

I. General information

NPI: 1134726508
Provider Name (Legal Business Name): AMERICAN BEAM CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2020
Last Update Date: 05/31/2024
Certification Date: 05/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9191 BOLSA AVE STE 207
WESTMINSTER CA
92683-5561
US

IV. Provider business mailing address

9191 BOLSA AVE STE 207
WESTMINSTER CA
92683-5561
US

V. Phone/Fax

Practice location:
  • Phone: 714-905-9229
  • Fax:
Mailing address:
  • Phone: 714-905-9229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: LUAN NGUYEN
Title or Position: CEO
Credential:
Phone: 714-905-9229