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General NPI Number Information
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NPI Number | 1558684886
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Entity Type | Organization
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Legal Business Name | MEDICAL PAIN MANAGEMENT CENTER
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Dates
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Enumeration Date | 03/01/2010
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Last Update Date | 03/01/2010
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Provider Practice Location Address
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Address Line | 1024 S. GARFIELD AVE.
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City | ALHAMBRA
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State | CA
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Zip | 92801
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Country | US
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Telephone | 626-282-0062
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Fax | 626-282-0062
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Provider Business Mailing Address
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Address Line | 1024 S. GARFIELD AVE.
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City | ALHAMBRA
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State | CA
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Zip | 91801
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Country | US
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Telephone | 626-282-0062
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Fax | 626-282-0062
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GUANG WU SHE
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Credential | L.AC.
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Telephone | 626-282-0062
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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 | ACU283
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License Number State | HI
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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 | AC4384
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License Number State | CA
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