MEDICARE: BEIJING CHINESE MEDICAL GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AC8524	CA

General Provider Information

NPI Number	:	1093982597
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEIJING CHINESE MEDICAL GROUP

Provider Business Mailing Address
First Line	:	3545 WILSHIRE BLVD
Second Line	:	#355
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-2354
Country	:	US
Telephone Number	:	213-389-3818
Fax Number	:	213-389-3819

Provider Business Practice Location Address
First Line	:	3545 WILSHIRE BLVD
Second Line	:	#355
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-2354
Country	:	US
Telephone Number	:	213-389-3818
Fax Number	:	213-389-3819

Authorized Official
Title or Position	:	ACUPUNCTURIST
Name	:	KYU HO ZEON
Credential	:	L.AC
Telephone Number	:	213-389-3818

Provider Enumeration Date	:	05/14/2008
Last Update Date	:	05/14/2008

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