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General NPI Number Information
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NPI Number | 1164889861
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Entity Type | Organization
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Legal Business Name | TAI WELLNESS GROUP
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Dates
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Enumeration Date | 01/26/2016
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Last Update Date | 01/26/2016
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Provider Practice Location Address
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Address Line | 221 S EUCLID AVE
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City | PASADENA
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State | CA
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Zip | 91101-2717
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Country | US
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Telephone | 626-466-5364
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Fax | 626-578-1619
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Provider Business Mailing Address
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Address Line | 221 S EUCLID AVE
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City | PASADENA
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State | CA
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Zip | 91101-2717
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Country | US
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Telephone | 626-466-5364
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Fax | 626-578-1619
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Authorized Official
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Title or Position | ACUPUNCTRIST
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Name | KUEIKU LIU
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Credential |
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Telephone | 626-466-5364
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | AC16237
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License Number State | CA
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