# FOUNTAIN OF YOUTH INTERGRATIVE MEDICAL GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538390075
- **Authorized official:** MR. LIN-HSING CHOU L.AC. (MANAGER)
- **Authorized official phone:** (626) 683-8550

## Contact information

- **Practice address:** 700 E WALNUT ST STE 1, PASADENA, CA 91101-1685
- **Practice address phone:** (626) 683-8550
- **Practice address fax:** (626) 683-8550
- **Mailing address:** 700 E WALNUT ST STE 1, PASADENA, CA 91101-1685
- **Mailing address phone:** (626) 683-8550
- **Mailing address fax:** (626) 683-8550

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | AC 13051 | CA | Yes |

## Other

- **Enumeration date:** 07/31/2009
- **Last updated:** 07/31/2009