MEDICARE: ACU CHIRO CLINIC

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	111N00000X	Chiropractor	DC29495	CA

General Provider Information

NPI Number	:	1821365867
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACU CHIRO CLINIC

Provider Business Mailing Address
First Line	:	3242 W 8TH ST
Second Line	:	SUITE 100
City	:	LOS ANGELES
State	:	CA
Zip	:	90005-2176
Country	:	US
Telephone Number	:	213-383-0007
Fax Number	:	213-383-0019

Provider Business Practice Location Address
First Line	:	3242 W 8TH ST
Second Line	:	SUITE 100
City	:	LOS ANGELES
State	:	CA
Zip	:	90005-2176
Country	:	US
Telephone Number	:	213-383-0007
Fax Number	:	213-383-0019

Authorized Official
Title or Position	:	DC / PRESIDENT
Name	:	DR. NELSON HEA LEE
Credential	:	DC
Telephone Number	:	213-383-0007

Provider Enumeration Date	:	11/18/2011
Last Update Date	:	11/18/2011

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