Provider Demographics
NPI:1700056629
Name:C & E ORIENTAL MEDICINE & MASSAGE CLINIC L.L.C.
Entity Type:Organization
Organization Name:C & E ORIENTAL MEDICINE & MASSAGE CLINIC L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DOCTOR OF ORIENTAL MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:WHITAKER
Authorized Official - Suffix:
Authorized Official - Credentials:DOM
Authorized Official - Phone:505-341-0543
Mailing Address - Street 1:6855 4TH ST NW
Mailing Address - Street 2:SUITE-D
Mailing Address - City:LOS RANCHOS DE ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-6100
Mailing Address - Country:US
Mailing Address - Phone:505-341-0543
Mailing Address - Fax:505-341-0543
Practice Address - Street 1:6855 4TH ST NW
Practice Address - Street 2:SUITE-D
Practice Address - City:LOS RANCHOS DE ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-6100
Practice Address - Country:US
Practice Address - Phone:505-341-0543
Practice Address - Fax:505-341-0543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM918171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty