Provider Demographics
NPI:1568628030
Name:CRYSTAL ACUPUNCTURE CENTER INC
Entity Type:Organization
Organization Name:CRYSTAL ACUPUNCTURE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MANN-YOUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:AC
Authorized Official - Phone:626-280-4888
Mailing Address - Street 1:33 E VALLEY BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-5152
Mailing Address - Country:US
Mailing Address - Phone:626-280-4888
Mailing Address - Fax:626-280-9488
Practice Address - Street 1:33 E VALLEY BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-5152
Practice Address - Country:US
Practice Address - Phone:626-280-4888
Practice Address - Fax:626-280-9488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8045171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty