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General NPI Number Information
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NPI Number | 1154554673
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Entity Type | Organization
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Legal Business Name | ACME CONSULTATIVE EVALUATION MEDICAL CENTER
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Dates
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Enumeration Date | 09/01/2009
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Last Update Date | 08/02/2011
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Provider Practice Location Address
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Address Line | 14482 BEACH BLVD # R
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City | WESTMINSTER
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State | CA
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Zip | 92683-5341
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Country | US
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Telephone | 714-889-7255
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Fax |
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Provider Business Mailing Address
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Address Line | 14482 BEACH BLVD # R
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City | WESTMINSTER
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State | CA
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Zip | 92683-5341
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Country | US
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Telephone | 714-889-7255
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | HOAN LAI
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Credential |
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Telephone | 714-889-7255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | G58330
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License Number State | CA
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