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General NPI Number Information
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NPI Number | 1033362611
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Entity Type | Organization
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Legal Business Name | CHI - COTTAGE HEALTH BY INGA, INC
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Dates
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Enumeration Date | 10/28/2008
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Last Update Date | 10/28/2008
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Provider Practice Location Address
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Address Line | 115 S. HARBOR BLVD SUITE F
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City | FULLERTON
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State | CA
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Zip | 92832
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Country | US
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Telephone | 714-879-9691
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Fax |
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Provider Business Mailing Address
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Address Line | 115 S. HARBOR BLVD SUITE F
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City | FULLERTON
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State | CA
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Zip | 92832
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Country | US
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Telephone | 714-879-9691
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Fax |
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Authorized Official
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Title or Position | CEO/ACUPUNCTURIST
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Name | MRS. INGA FORAHANCHI
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Credential | LAC
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Telephone | 714-879-9691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC9541
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC7312
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License Number State | CA
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