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General NPI Number Information
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NPI Number | 1730453127
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Entity Type | Organization
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Legal Business Name | PANS MEDICAL CENTER
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Dates
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Enumeration Date | 03/02/2012
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Last Update Date | 03/02/2012
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Provider Practice Location Address
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Address Line | 4790 IRVINE BLVD SUITE 104
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City | IRVINE
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State | CA
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Zip | 92620-1973
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Country | US
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Telephone | 626-688-2526
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Fax |
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Provider Business Mailing Address
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Address Line | 20 LAKEPINES
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City | IRVINE
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State | CA
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Zip | 92620-1913
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Country | US
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Telephone | 626-688-2526
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURE
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Name | JIANG HONG ZHENG
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Credential |
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Telephone | 626-688-2526
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | AC14069
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License Number State | CA
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