Provider Demographics
NPI:1073203352
Name:ULTIMATE CARE ACUPUNCTURE & HERBS CENTER, INC.
Entity Type:Organization
Organization Name:ULTIMATE CARE ACUPUNCTURE & HERBS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST AND HERBALIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARYAM
Authorized Official - Middle Name:NOURI
Authorized Official - Last Name:SAFIYA
Authorized Official - Suffix:
Authorized Official - Credentials:DACM LAC
Authorized Official - Phone:424-777-5380
Mailing Address - Street 1:1516 WESTWOOD BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-5616
Mailing Address - Country:US
Mailing Address - Phone:424-777-5380
Mailing Address - Fax:424-777-4090
Practice Address - Street 1:1516 WESTWOOD BLVD STE 104
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-5616
Practice Address - Country:US
Practice Address - Phone:424-777-5380
Practice Address - Fax:424-777-4090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty