Provider Demographics
NPI:1114264405
Name:CLINIC OF HOPE ACUPUNCTURE INC.
Entity Type:Organization
Organization Name:CLINIC OF HOPE ACUPUNCTURE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:FAN LAN
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, OMD, PHD
Authorized Official - Phone:626-993-5354
Mailing Address - Street 1:2556 KELBURN AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-3146
Mailing Address - Country:US
Mailing Address - Phone:626-993-5354
Mailing Address - Fax:
Practice Address - Street 1:3131 SANTA ANITA AVE STE 104
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91733-1369
Practice Address - Country:US
Practice Address - Phone:626-279-9499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7398171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty