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General NPI Number Information
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NPI Number | 1538237557
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Entity Type | Organization
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Legal Business Name | BEVERLY HILLS INTEGRATIVE MEDICINE GROUP INC
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 11/06/2018
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Provider Practice Location Address
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Address Line | 7414 BEVERLY BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90036-2725
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Country | US
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Telephone | 310-989-8668
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Fax | 323-297-2471
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Provider Business Mailing Address
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Address Line | 27 PALMETTO DR APT A
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City | ALHAMBRA
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State | CA
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Zip | 91801-5907
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Country | US
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Telephone | 310-989-8668
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Fax | 323-297-2471
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Authorized Official
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Title or Position | CEO
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Name | XIAO L JIANG
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Credential |
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Telephone | 310-989-8668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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