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General NPI Number Information
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NPI Number | 1619373560
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Entity Type | Organization
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Legal Business Name | E&W HEALTH CLINIC
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Dates
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Enumeration Date | 11/05/2014
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Last Update Date | 11/05/2014
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Provider Practice Location Address
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Address Line | 120 S SIERRA MADRE BLVD APT 307
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City | PASADENA
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State | CA
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Zip | 91107-4153
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Country | US
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Telephone | 626-382-8858
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 81144
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City | SAN MARINO
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State | CA
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Zip | 91118-1144
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Country | US
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Telephone | 626-382-8858
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Fax |
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Authorized Official
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Title or Position | L.AC
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Name | WEIWEN LAI
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Credential | ACUPUNCTURIST
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Telephone | 626-382-8858
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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 | AC8188
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License Number State | CA
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