Provider Demographics
NPI:1760637417
Name:BALANCE & HARMONY WELLNESS, INC.
Entity Type:Organization
Organization Name:BALANCE & HARMONY WELLNESS, INC.
Other - Org Name:BALANCE & HARMONY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SANG
Authorized Official - Middle Name:KUN
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LAC, DIPLOOM
Authorized Official - Phone:626-461-5228
Mailing Address - Street 1:520 S KINGSLEY DR APT 307
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-3510
Mailing Address - Country:US
Mailing Address - Phone:626-359-8889
Mailing Address - Fax:626-305-3149
Practice Address - Street 1:301 W HUNTINGTON DR STE 112
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-3478
Practice Address - Country:US
Practice Address - Phone:626-461-5228
Practice Address - Fax:000-000-0000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-21
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 10623171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5989736Medicaid