Provider Demographics
NPI:1568706794
Name:ALTHEA ACUPUNCTURE ARTS INC
Entity Type:Organization
Organization Name:ALTHEA ACUPUNCTURE ARTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HSIEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FANG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:626-710-6055
Mailing Address - Street 1:65 N 1ST AVE
Mailing Address - Street 2:#204
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-3207
Mailing Address - Country:US
Mailing Address - Phone:626-710-6055
Mailing Address - Fax:
Practice Address - Street 1:65 N 1ST AVE
Practice Address - Street 2:#204
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3207
Practice Address - Country:US
Practice Address - Phone:626-710-6055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-09
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC3406634OtherCALIFORNIA STATE CORP NUMBER