Provider Demographics
NPI:1801943022
Name:3 ANGELS HEALTH CENTER, INC.
Entity type:Organization
Organization Name:3 ANGELS HEALTH CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EUN JEONG
Authorized Official - Middle Name:
Authorized Official - Last Name:SONG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LAC
Authorized Official - Phone:310-859-7696
Mailing Address - Street 1:250 N ROBERTSON BLVD
Mailing Address - Street 2:SUITE 516
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-1788
Mailing Address - Country:US
Mailing Address - Phone:310-859-7696
Mailing Address - Fax:310-859-7699
Practice Address - Street 1:250 N ROBERTSON BLVD
Practice Address - Street 2:SUITE 516
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1788
Practice Address - Country:US
Practice Address - Phone:310-859-7696
Practice Address - Fax:310-859-7699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12865171100000X
CAAC10601171100000X
CAAC8225171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty