Provider Demographics
NPI:1245562503
Name:MEGALIFE, INC.
Entity Type:Organization
Organization Name:MEGALIFE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC MS
Authorized Official - Phone:714-228-0618
Mailing Address - Street 1:PO BOX 2062
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90702-2062
Mailing Address - Country:US
Mailing Address - Phone:714-228-0618
Mailing Address - Fax:
Practice Address - Street 1:6122 ORANGETHORPE AVE
Practice Address - Street 2:108
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90620-1300
Practice Address - Country:US
Practice Address - Phone:714-228-0618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA12002171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty