Provider Demographics
NPI:1114243508
Name:IRVINE MERIDIAN HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:IRVINE MERIDIAN HEALTH CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHUN-MING
Authorized Official - Middle Name:
Authorized Official - Last Name:FU
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:949-232-4302
Mailing Address - Street 1:15785 LAGUNA CANYON RD
Mailing Address - Street 2:SUITE 370
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3165
Mailing Address - Country:US
Mailing Address - Phone:949-232-4302
Mailing Address - Fax:949-419-0966
Practice Address - Street 1:15785 LAGUNA CANYON RD
Practice Address - Street 2:SUITE 370
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3165
Practice Address - Country:US
Practice Address - Phone:949-232-4302
Practice Address - Fax:949-419-0966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-12
Last Update Date:2013-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12004171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty