Provider Demographics
NPI:1821641911
Name:QUEEN BEE ACUPUNCTURE INC.
Entity Type:Organization
Organization Name:QUEEN BEE ACUPUNCTURE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LEESA
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLENTINE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:213-265-1606
Mailing Address - Street 1:2219 W OLIVE AVE STE 116
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-2625
Mailing Address - Country:US
Mailing Address - Phone:213-265-1606
Mailing Address - Fax:
Practice Address - Street 1:3487 CAHUENGA BLVD W STE B
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90068-1338
Practice Address - Country:US
Practice Address - Phone:818-254-8483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-18
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1073170692OtherISSUED BY NPPES