Provider Demographics
NPI:1417399700
Name:GONG, HELEN HUI HUA (L AC)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:HUI HUA
Last Name:GONG
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5230 CORINGA DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-1035
Mailing Address - Country:US
Mailing Address - Phone:626-524-1868
Mailing Address - Fax:
Practice Address - Street 1:5230 CORINGA DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-1035
Practice Address - Country:US
Practice Address - Phone:626-524-1868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-26
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 15198171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist