Provider Demographics
NPI:1720519648
Name:BEST BURBANK ACUPUNCTURE & HERBS, INC
Entity Type:Organization
Organization Name:BEST BURBANK ACUPUNCTURE & HERBS, INC
Other - Org Name:N/A
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ACUPUNCTURIST/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:HAI
Authorized Official - Middle Name:O
Authorized Official - Last Name:KONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-558-5954
Mailing Address - Street 1:511 N VICTORY BLVD
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-1737
Mailing Address - Country:US
Mailing Address - Phone:818-558-5954
Mailing Address - Fax:
Practice Address - Street 1:511 N VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-1737
Practice Address - Country:US
Practice Address - Phone:818-558-5954
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEST BURBANK ACUPUNCTURE & HERBS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3932241Medicare PIN