Provider Demographics
NPI:1033362611
Name:CHI - COTTAGE HEALTH BY INGA, INC
Entity Type:Organization
Organization Name:CHI - COTTAGE HEALTH BY INGA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ACUPUNCTURIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:INGA
Authorized Official - Middle Name:
Authorized Official - Last Name:FORAHANCHI
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:714-879-9691
Mailing Address - Street 1:115 S. HARBOR BLVD
Mailing Address - Street 2:SUITE F
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832
Mailing Address - Country:US
Mailing Address - Phone:714-879-9691
Mailing Address - Fax:
Practice Address - Street 1:115 S. HARBOR BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832
Practice Address - Country:US
Practice Address - Phone:714-879-9691
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC7312171100000X
CAAC9541171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty