Provider Demographics
NPI:1639398704
Name:BUDDHIST TZU CHI MEDICAL FOUNDATION
Entity Type:Organization
Organization Name:BUDDHIST TZU CHI MEDICAL FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:FEN-LIEN
Authorized Official - Middle Name:
Authorized Official - Last Name:JUANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-427-9598
Mailing Address - Street 1:9620 FLAIR DR
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731-3005
Mailing Address - Country:US
Mailing Address - Phone:626-427-9598
Mailing Address - Fax:
Practice Address - Street 1:1000 S. GARFIELD AVE.
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-4709
Practice Address - Country:US
Practice Address - Phone:626-281-3383
Practice Address - Fax:626-281-5303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health