Provider Demographics
NPI:1689898470
Name:FAR EAST HOLISTIC HEALTH CARE CENTER INC
Entity Type:Organization
Organization Name:FAR EAST HOLISTIC HEALTH CARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:G
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSED ACUPUNCTURI
Authorized Official - Phone:626-441-6639
Mailing Address - Street 1:1530 LINCOLN BLVD
Mailing Address - Street 2:SUITE #D
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-2735
Mailing Address - Country:US
Mailing Address - Phone:310-576-0508
Mailing Address - Fax:310-576-0518
Practice Address - Street 1:1530 LINCOLN BLVD
Practice Address - Street 2:SUITE #D
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-2735
Practice Address - Country:US
Practice Address - Phone:310-576-0508
Practice Address - Fax:310-576-0518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC2254171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty