Provider Demographics
NPI:1619373560
Name:E&W HEALTH CLINIC
Entity type:Organization
Organization Name:E&W HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:L.AC
Authorized Official - Prefix:
Authorized Official - First Name:WEIWEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAI
Authorized Official - Suffix:
Authorized Official - Credentials:ACUPUNCTURIST
Authorized Official - Phone:626-382-8858
Mailing Address - Street 1:PO BOX 81144
Mailing Address - Street 2:
Mailing Address - City:SAN MARINO
Mailing Address - State:CA
Mailing Address - Zip Code:91118-1144
Mailing Address - Country:US
Mailing Address - Phone:626-382-8858
Mailing Address - Fax:
Practice Address - Street 1:120 S SIERRA MADRE BLVD APT 307
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-4153
Practice Address - Country:US
Practice Address - Phone:626-382-8858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8188261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain