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General NPI Number Information
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NPI Number | 1871967935
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Entity Type | Organization
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Legal Business Name | 5 ELEMENTS ACUPUNCTURE CLINIC INC
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Dates
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Enumeration Date | 11/30/2015
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Last Update Date | 11/30/2015
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Provider Practice Location Address
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Address Line | 2840 LONG BEACH BLVD SUITE 205
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City | LONG BEACH
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State | CA
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Zip | 90806
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Country | US
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Telephone | 213-700-3255
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Fax |
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Provider Business Mailing Address
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Address Line | 19905 CHRISTINA CIR
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City | CERRITOS
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State | CA
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Zip | 90703
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Country | US
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Telephone | 213-700-3255
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | HEA EUN JANG
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Credential |
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Telephone | 213-700-3255
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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 | AC12361
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License Number State | CA
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