Provider Demographics
NPI:1336601640
Name:CHINESE MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:CHINESE MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YONG
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSED ACUPUNCTURI
Authorized Official - Phone:678-232-5425
Mailing Address - Street 1:5150 BUFORD HWY NE STE B170
Mailing Address - Street 2:
Mailing Address - City:DORAVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30340-1163
Mailing Address - Country:US
Mailing Address - Phone:678-232-5425
Mailing Address - Fax:678-339-0817
Practice Address - Street 1:5150 BUFORD HWY NE STE B170
Practice Address - Street 2:
Practice Address - City:DORAVILLE
Practice Address - State:GA
Practice Address - Zip Code:30340-1163
Practice Address - Country:US
Practice Address - Phone:678-232-5425
Practice Address - Fax:678-339-0817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-04
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty