Provider Demographics
NPI:1639219256
Name:ACUPUNCTURE-MEDICAL PAIN MANAGEMENT CENTERS
Entity Type:Organization
Organization Name:ACUPUNCTURE-MEDICAL PAIN MANAGEMENT CENTERS
Other - Org Name:SOURCE REHAB P.T.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:HING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-699-3369
Mailing Address - Street 1:PO BOX 27294
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92809-0108
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1450 E 17TH ST STE 220
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-8510
Practice Address - Country:US
Practice Address - Phone:310-699-3369
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty