Healthcare Provider Details

I. General information

NPI: 1346131323
Provider Name (Legal Business Name): LEGACY ORIENTAL MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2025
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9163 W FLAMINGO RD STE 110
LAS VEGAS NV
89147-6458
US

IV. Provider business mailing address

9163 W FLAMINGO RD STE 110
LAS VEGAS NV
89147-6458
US

V. Phone/Fax

Practice location:
  • Phone: 702-898-7899
  • Fax: 702-898-7898
Mailing address:
  • Phone: 702-898-7899
  • Fax: 702-898-7898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: DR. HUIWEN HUIWEN
Title or Position: DIRECTOR
Credential: OMD
Phone: 702-501-7988