Provider Demographics
NPI:1942655014
Name:LIGHTHOUSE WELLNESS ACUPUNCTURE & HERBS, INC.
Entity type:Organization
Organization Name:LIGHTHOUSE WELLNESS ACUPUNCTURE & HERBS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LI HUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-928-5338
Mailing Address - Street 1:8134 WISHING WELL LN
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91708-9310
Mailing Address - Country:US
Mailing Address - Phone:909-800-6838
Mailing Address - Fax:
Practice Address - Street 1:507 MISSION ST
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91030-3035
Practice Address - Country:US
Practice Address - Phone:818-928-5338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-26
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC16179171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty