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NPI Code Detail

MEDICARE: UNITED UNIVERSITY OF LOS ANGELES, INC.

MEDICARE: UNITED UNIVERSITY OF LOS ANGELES, INC.
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
1171100000XAcupuncturistAC5686CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AC5686OTHERCAACUPUNCTURE LICENSE

General Provider Information

NPI Number : 1396867693
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNITED UNIVERSITY OF LOS ANGELES, INC.
Provider Business Mailing Address
First Line : 18335 EAST VALLEY BLVD.
Second Line :
City : LA PUENTE
State : CA
Zip : 91744-5968
Country : US
Telephone Number : 626-581-7656
Fax Number : 909-628-1085
Provider Business Practice Location Address
First Line : 18335 EAST VALLEY BLVD.
Second Line :
City : LA PUENTE
State : CA
Zip : 91744-5968
Country : US
Telephone Number : 626-581-7656
Fax Number : 909-628-1085
Authorized Official
Title or Position : OWNER
Name : SHUHONG TINA HOU
Credential : L.AC.
Telephone Number : 626-581-7656
Provider Enumeration Date : 04/06/2007
Last Update Date : 08/22/2020

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