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General NPI Number Information
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NPI Number | 1942774385
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Entity Type | Organization
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Legal Business Name | SS ACU PAIN RELIEF CLINIC
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Dates
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Enumeration Date | 01/18/2019
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Last Update Date | 01/18/2019
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Provider Practice Location Address
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Address Line | 19139 BLOOMFIELD AVE
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City | CERRITOS
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State | CA
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Zip | 90703-7104
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Country | US
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Telephone | 626-638-2818
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Fax |
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Provider Business Mailing Address
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Address Line | 19139 BLOOMFIELD AVE
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City | CERRITOS
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State | CA
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Zip | 90703-7104
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Country | US
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Telephone | 626-638-2818
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Fax |
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Authorized Official
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Title or Position | BILLER
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Name | PERLA RAMIREZ
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Credential |
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Telephone | 626-676-5940
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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 |
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License Number State |
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