Provider Demographics
NPI:1609927391
Name:COMPLEMED ACUPUNCTURE CENTER INC
Entity Type:Organization
Organization Name:COMPLEMED ACUPUNCTURE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO PARTNER VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:NASSERAZARI
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:310-263-0088
Mailing Address - Street 1:14623 HAWTHORNE BLVD
Mailing Address - Street 2:# 402
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260
Mailing Address - Country:US
Mailing Address - Phone:310-263-0088
Mailing Address - Fax:310-263-1188
Practice Address - Street 1:14623 HAWTHORNE BLVD
Practice Address - Street 2:# 402
Practice Address - City:LAWNDALE
Practice Address - State:CA
Practice Address - Zip Code:90260
Practice Address - Country:US
Practice Address - Phone:310-263-0088
Practice Address - Fax:310-263-1188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty