Provider Demographics
NPI:1598184038
Name:JADE SPRINGS ACUPUNCTURE & HERBS, INC.
Entity Type:Organization
Organization Name:JADE SPRINGS ACUPUNCTURE & HERBS, INC.
Other - Org Name:JANET CHUNG ACUPUNCTURE & HERBAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUNG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, DIPLOM
Authorized Official - Phone:424-248-9767
Mailing Address - Street 1:916 15TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-3147
Mailing Address - Country:US
Mailing Address - Phone:424-248-9767
Mailing Address - Fax:
Practice Address - Street 1:11500 W OLYMPIC BLVD STE 636
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-1525
Practice Address - Country:US
Practice Address - Phone:424-248-9767
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-14
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15738171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty