Provider Demographics
NPI:1811129091
Name:ASIAN PACIFIC HEALTH CARE VENTURE, INC.
Entity type:Organization
Organization Name:ASIAN PACIFIC HEALTH CARE VENTURE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KAZUE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIBATA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-644-3880
Mailing Address - Street 1:4216 FOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-2256
Mailing Address - Country:US
Mailing Address - Phone:323-644-3880
Mailing Address - Fax:323-660-0935
Practice Address - Street 1:180 UNION PL
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-5715
Practice Address - Country:US
Practice Address - Phone:323-644-3880
Practice Address - Fax:323-660-0935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-20
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care