Provider Demographics
NPI:1568876449
Name:NATURAL BALANCE MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:NATURAL BALANCE MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KUO HUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:LIAO
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:626-616-9319
Mailing Address - Street 1:130 W ROUTE 66 STE 312
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-6252
Mailing Address - Country:US
Mailing Address - Phone:626-888-1394
Mailing Address - Fax:
Practice Address - Street 1:130 W ROUTE 66 STE 312
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-6252
Practice Address - Country:US
Practice Address - Phone:626-888-1394
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-18
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC15376171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty