Provider Demographics
NPI:1093982597
Name:BEIJING CHINESE MEDICAL GROUP
Entity Type:Organization
Organization Name:BEIJING CHINESE MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:KYU HO
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEON
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:213-389-3818
Mailing Address - Street 1:3545 WILSHIRE BLVD
Mailing Address - Street 2:#355
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-2354
Mailing Address - Country:US
Mailing Address - Phone:213-389-3818
Mailing Address - Fax:213-389-3819
Practice Address - Street 1:3545 WILSHIRE BLVD
Practice Address - Street 2:#355
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-2354
Practice Address - Country:US
Practice Address - Phone:213-389-3818
Practice Address - Fax:213-389-3819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8524171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty