Provider Demographics
NPI:1437806635
Name:ANAHATA HEALING GROUP
Entity Type:Organization
Organization Name:ANAHATA HEALING GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIA
Authorized Official - Middle Name:SOKUNTHEAR
Authorized Official - Last Name:HEM
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:213-784-9529
Mailing Address - Street 1:2120 HUNTINGTON DR STE A
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91030-4984
Mailing Address - Country:US
Mailing Address - Phone:213-784-9529
Mailing Address - Fax:
Practice Address - Street 1:2120 HUNTINGTON DR STE A
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91030-4984
Practice Address - Country:US
Practice Address - Phone:213-784-9529
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date: