Provider Demographics
NPI:1881170397
Name:EAST WEST ACUPUNCTURE CENTER
Entity type:Organization
Organization Name:EAST WEST ACUPUNCTURE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ROXANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:916-786-8100
Mailing Address - Street 1:151 N SUNRISE AVE STE 819
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-2928
Mailing Address - Country:US
Mailing Address - Phone:191-678-6810
Mailing Address - Fax:
Practice Address - Street 1:151 N SUNRISE AVE STE 819
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-2928
Practice Address - Country:US
Practice Address - Phone:916-786-8100
Practice Address - Fax:916-786-8105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-17
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7403261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center