Provider Demographics
NPI:1548293178
Name:GOLDEN RAINBOW ACUPUNCTURE
Entity type:Organization
Organization Name:GOLDEN RAINBOW ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HONG
Authorized Official - Middle Name:
Authorized Official - Last Name:JIN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:626-369-6658
Mailing Address - Street 1:2219 S HACIENDA BLVD
Mailing Address - Street 2:#204
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-4639
Mailing Address - Country:US
Mailing Address - Phone:626-369-6658
Mailing Address - Fax:626-855-4302
Practice Address - Street 1:2219 S HACIENDA BLVD
Practice Address - Street 2:#204
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-4639
Practice Address - Country:US
Practice Address - Phone:626-369-6658
Practice Address - Fax:626-855-4302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5051171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty