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General NPI Number Information
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NPI Number | 1548293178
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Entity Type | Organization
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Legal Business Name | GOLDEN RAINBOW ACUPUNCTURE
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2219 S HACIENDA BLVD #204
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City | HACIENDA HEIGHTS
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State | CA
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Zip | 91745-4639
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Country | US
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Telephone | 626-369-6658
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Fax | 626-855-4302
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Provider Business Mailing Address
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Address Line | 2219 S HACIENDA BLVD #204
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City | HACIENDA HEIGHTS
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State | CA
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Zip | 91745-4639
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Country | US
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Telephone | 626-369-6658
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Fax | 626-855-4302
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Authorized Official
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Title or Position | CEO
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Name | HONG JIN
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Credential | L.AC.
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Telephone | 626-369-6658
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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 | AC5051
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License Number State | CA
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