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General NPI Number Information
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NPI Number | 1477446870
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Entity Type | Organization
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Legal Business Name | THE BRIDGE TO A DREAM INC.
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Dates
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Enumeration Date | 06/03/2025
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 1126 N BROOKHURST ST
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City | ANAHEIM
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State | CA
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Zip | 92801-1702
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Country | US
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Telephone | 714-515-9293
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Fax |
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Provider Business Mailing Address
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Address Line | 11733 CITRA CIR
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City | WHITTIER
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State | CA
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Zip | 90601-2178
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Country | US
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Telephone | 714-515-9293
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | HONGJUN AHN
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Credential |
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Telephone | 714-515-9293
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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