Provider Demographics
NPI:1558677419
Name:BEN CAO TANG ACUPUNCTURE HERBS CENTER
Entity Type:Organization
Organization Name:BEN CAO TANG ACUPUNCTURE HERBS CENTER
Other - Org Name:BCT ACUPUNCTURE HERBS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:CADE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:323-226-0188
Mailing Address - Street 1:1011 N BROADWAY STE 203
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-1452
Mailing Address - Country:US
Mailing Address - Phone:323-226-0188
Mailing Address - Fax:626-457-6022
Practice Address - Street 1:1011 N BROADWAY STE 203
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-1452
Practice Address - Country:US
Practice Address - Phone:323-226-0188
Practice Address - Fax:626-457-6022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-28
Last Update Date:2010-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL.AC 7326320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities