Provider Demographics
NPI:1518409648
Name:UNITED ALTERNATIVE MEDICAL GROUP INC.
Entity Type:Organization
Organization Name:UNITED ALTERNATIVE MEDICAL GROUP INC.
Other - Org Name:T.Y. WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOI
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:213-621-2652
Mailing Address - Street 1:706 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-2442
Mailing Address - Country:US
Mailing Address - Phone:213-621-2652
Mailing Address - Fax:213-621-2654
Practice Address - Street 1:706 W 1ST ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-2442
Practice Address - Country:US
Practice Address - Phone:213-621-2652
Practice Address - Fax:213-621-2654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC13691171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty