Provider Demographics
NPI:1346542917
Name:ACUPUNCTURE PAIN AND HEALTHCARE, INC.
Entity Type:Organization
Organization Name:ACUPUNCTURE PAIN AND HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEN
Authorized Official - Middle Name:N
Authorized Official - Last Name:CHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:323-314-3578
Mailing Address - Street 1:1109 W SAN BERNARDINO RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91722-4163
Mailing Address - Country:US
Mailing Address - Phone:818-906-0808
Mailing Address - Fax:
Practice Address - Street 1:4955 VAN NUYS BLVD
Practice Address - Street 2:SUITE 405
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-1801
Practice Address - Country:US
Practice Address - Phone:818-906-0808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-02
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC4054171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty