Provider Demographics
NPI:1073838009
Name:CALIFORNIA ACUPUNCTURE & HERBAL MEDICINE, INC.
Entity Type:Organization
Organization Name:CALIFORNIA ACUPUNCTURE & HERBAL MEDICINE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:SL
Authorized Official - Last Name:CHOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-286-0162
Mailing Address - Street 1:PO BOX 389
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91778-0389
Mailing Address - Country:US
Mailing Address - Phone:626-286-0162
Mailing Address - Fax:213-687-8086
Practice Address - Street 1:360 E 1ST ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-3902
Practice Address - Country:US
Practice Address - Phone:213-687-8866
Practice Address - Fax:213-687-8086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-01
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC4483171100000X
CAAC6748171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA0044830OtherBLUE SHIELD OF CALIFORNIA
CACA0067480OtherBLUE SHIELD OF CALIFORNIA