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General NPI Number Information
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NPI Number | 1184068454
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Entity Type | Organization
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Legal Business Name | EASTERN MEDICINE & ACUPUNCTURE CLINIC, INC
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Dates
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Enumeration Date | 04/17/2013
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Last Update Date | 04/17/2013
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Provider Practice Location Address
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Address Line | 3523 W OLYMPIC BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90019-3502
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Country | US
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Telephone | 323-733-8887
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Fax |
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Provider Business Mailing Address
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Address Line | 3523 W OLYMPIC BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90019-3502
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Country | US
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Telephone | 323-733-8887
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SIU LIN JIN
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Credential |
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Telephone | 323-733-8887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | AC 9445
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License Number State | CA
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