Provider Demographics
NPI:1922214188
Name:ANAHEIM HEALTH CARE CENTER
Entity Type:Organization
Organization Name:ANAHEIM HEALTH CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRIMERY CARE PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JUK
Authorized Official - Middle Name:L
Authorized Official - Last Name:TING
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:714-484-1280
Mailing Address - Street 1:1125 N MAGNOLIA AVE
Mailing Address - Street 2:SUIET 115
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-2638
Mailing Address - Country:US
Mailing Address - Phone:714-484-1280
Mailing Address - Fax:714-484-1358
Practice Address - Street 1:1125 N MAGNOLIA AVE
Practice Address - Street 2:SUIET 115
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-2638
Practice Address - Country:US
Practice Address - Phone:714-484-1280
Practice Address - Fax:714-484-1358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7323207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty