Provider Demographics
NPI:1003128950
Name:CA ACU, INC.
Entity Type:Organization
Organization Name:CA ACU, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHABNAM
Authorized Official - Middle Name:
Authorized Official - Last Name:POURHASSANI
Authorized Official - Suffix:
Authorized Official - Credentials:MS LAC
Authorized Official - Phone:949-309-7359
Mailing Address - Street 1:180 NEWPORT CENTER DRIVE
Mailing Address - Street 2:SUITE 145
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660
Mailing Address - Country:US
Mailing Address - Phone:949-309-7359
Mailing Address - Fax:949-588-6858
Practice Address - Street 1:180 NEWPORT CENTER DRIVE
Practice Address - Street 2:SUITE 145
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660
Practice Address - Country:US
Practice Address - Phone:949-309-7359
Practice Address - Fax:949-588-6858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-08
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 12745171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty