Provider Demographics
NPI:1053995530
Name:MEDITREE ACUPUNCTURE CLINIC INC
Entity type:Organization
Organization Name:MEDITREE ACUPUNCTURE CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAELIM
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:ACUPUNCTURIST
Authorized Official - Phone:818-833-5977
Mailing Address - Street 1:609 PADILLA ST
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-1121
Mailing Address - Country:US
Mailing Address - Phone:818-833-5977
Mailing Address - Fax:818-270-2919
Practice Address - Street 1:13519 HUBBARD ST
Practice Address - Street 2:
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-4419
Practice Address - Country:US
Practice Address - Phone:818-833-5977
Practice Address - Fax:818-270-2919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty