Provider Demographics
NPI:1093738494
Name:SHIN ACUPUNCTURE AND HERBS, INC.
Entity Type:Organization
Organization Name:SHIN ACUPUNCTURE AND HERBS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KYO
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:DC, LAC
Authorized Official - Phone:818-240-6163
Mailing Address - Street 1:435 ARDEN AVE STE 510
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-1137
Mailing Address - Country:US
Mailing Address - Phone:818-240-6163
Mailing Address - Fax:818-240-3735
Practice Address - Street 1:435 ARDEN AVE STE 510
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-1137
Practice Address - Country:US
Practice Address - Phone:818-240-6163
Practice Address - Fax:818-240-3735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111N00000X, 171100000X
CAAC6735171100000X
CAAC8235171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty