Provider Demographics
NPI:1003012725
Name:ELIM HEALTH CENTER,INC
Entity type:Organization
Organization Name:ELIM HEALTH CENTER,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:M
Authorized Official - Last Name:CUA
Authorized Official - Suffix:
Authorized Official - Credentials:OMD
Authorized Official - Phone:626-307-9400
Mailing Address - Street 1:8526E.GARVEY AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-2765
Mailing Address - Country:US
Mailing Address - Phone:626-307-9400
Mailing Address - Fax:626-307-9445
Practice Address - Street 1:8526 GARVEY AVE
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-2765
Practice Address - Country:US
Practice Address - Phone:626-307-9400
Practice Address - Fax:626-307-9445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA12760171100000X
CAA052694208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Not Answered208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty