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General NPI Number Information
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NPI Number | 1356595854
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Entity Type | Organization
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Legal Business Name | LC LIVEWELL INC
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Dates
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Enumeration Date | 11/11/2008
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Last Update Date | 02/01/2022
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Provider Practice Location Address
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Address Line | 625 S FAIR OAKS AVE # 225
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City | PASADENA
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State | CA
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Zip | 91105-2613
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Country | US
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Telephone | 162-653-8011
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Fax |
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Provider Business Mailing Address
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Address Line | 625 S FAIR OAKS AVE STE 225
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City | PASADENA
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State | CA
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Zip | 91105-2613
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Country | US
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Telephone | 62-639-6179
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Fax | 626-396-1799
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Authorized Official
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Title or Position | CEO
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Name | DR. SHUNCHIH LIN
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Credential | LAC
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Telephone | 626-396-1799
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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 | AC10114
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License Number State | CA
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