MEDICARE: TAIHO WELLNESS CENTER

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

General Provider Information

NPI Number	:	1265075212
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAIHO WELLNESS CENTER

Provider Business Mailing Address
First Line	:	2373 S HACIENDA BLVD
Second Line	:
City	:	HACIENDA HEIGHTS
State	:	CA
Zip	:	91745-4613
Country	:	US
Telephone Number	:	626-977-9188
Fax Number	:

Provider Business Practice Location Address
First Line	:	2373 S HACIENDA BLVD
Second Line	:
City	:	HACIENDA HEIGHTS
State	:	CA
Zip	:	91745-4613
Country	:	US
Telephone Number	:	626-977-9188
Fax Number	:

Authorized Official
Title or Position	:	ACUPUNCTURIST
Name	:	RONGPIN FU
Credential	:	LA.C
Telephone Number	:	626-977-9188

Provider Enumeration Date	:	10/22/2019
Last Update Date	:	10/22/2019

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Directions to “TAIHO WELLNESS CENTER ” Practice Location

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