Provider Demographics
NPI:1376806612
Name:SHANGRILA CARE INC.
Entity Type:Organization
Organization Name:SHANGRILA CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YAOYU
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:818-644-2171
Mailing Address - Street 1:881 ALMA REAL DR
Mailing Address - Street 2:T - 04
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-3731
Mailing Address - Country:US
Mailing Address - Phone:310-230-0008
Mailing Address - Fax:
Practice Address - Street 1:881 ALMA REAL DR
Practice Address - Street 2:T - 04
Practice Address - City:PACIFIC PALISADES
Practice Address - State:CA
Practice Address - Zip Code:90272-3731
Practice Address - Country:US
Practice Address - Phone:310-230-0008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No173C00000XOther Service ProvidersReflexologistGroup - Multi-Specialty