Provider Demographics
NPI:1538237557
Name:BEVERLY HILLS INTEGRATIVE MEDICINE GROUP INC
Entity type:Organization
Organization Name:BEVERLY HILLS INTEGRATIVE MEDICINE GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:XIAO
Authorized Official - Middle Name:L
Authorized Official - Last Name:JIANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-989-8668
Mailing Address - Street 1:27 PALMETTO DR APT A
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-5907
Mailing Address - Country:US
Mailing Address - Phone:310-989-8668
Mailing Address - Fax:323-297-2471
Practice Address - Street 1:7414 BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-2725
Practice Address - Country:US
Practice Address - Phone:310-989-8668
Practice Address - Fax:323-297-2471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty