MEDICARE: AMERICAN EASTERN WESTERN MEDICAL INS

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	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1225060627
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN EASTERN WESTERN MEDICAL INS

Provider Business Mailing Address
First Line	:	924 DOVERFIELD AVE
Second Line	:
City	:	HACIENDA HEIGHTS
State	:	CA
Zip	:	91748
Country	:	US
Telephone Number	:	626-913-0588
Fax Number	:

Provider Business Practice Location Address
First Line	:	19271 COLIMA RD STE D
Second Line	:
City	:	ROWLAND HEIGHTS
State	:	CA
Zip	:	91748-3006
Country	:	US
Telephone Number	:	626-913-0588
Fax Number	:

Authorized Official
Title or Position	:	CHAIRMAN/OWMER
Name	:	NANCY HOU
Credential	:	OWNER
Telephone Number	:	626-913-0588

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	08/11/2007

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