Provider Demographics
NPI:1568781102
Name:BELLEVIE HEALTHCARE CORPORATION
Entity Type:Organization
Organization Name:BELLEVIE HEALTHCARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:CHUNYEN
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC, LAC
Authorized Official - Phone:714-726-1841
Mailing Address - Street 1:12942 ELM TREE LN
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-1132
Mailing Address - Country:US
Mailing Address - Phone:714-726-1841
Mailing Address - Fax:909-248-0171
Practice Address - Street 1:1135 S. GRAND AVE
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-4119
Practice Address - Country:US
Practice Address - Phone:714-726-1841
Practice Address - Fax:909-248-0171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-21
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-31398111N00000X
CA13716171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty