Provider Demographics
NPI:1679780472
Name:H&M ACUPUNCTURE CLINIC,APROFESSIONAL MEDICAL CORPORATION
Entity Type:Organization
Organization Name:H&M ACUPUNCTURE CLINIC,APROFESSIONAL MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAHSHID
Authorized Official - Middle Name:
Authorized Official - Last Name:SABOURI
Authorized Official - Suffix:
Authorized Official - Credentials:ACUPUNCTURIST
Authorized Official - Phone:818-274-4423
Mailing Address - Street 1:20841 VENTURA BLVD#170
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364
Mailing Address - Country:US
Mailing Address - Phone:818-274-4423
Mailing Address - Fax:818-703-9125
Practice Address - Street 1:6400 CANOGA AVE STE 333
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-2492
Practice Address - Country:US
Practice Address - Phone:818-274-4423
Practice Address - Fax:818-703-9125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10646171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty