Organization
IMAGEN & CHRYSTAL INC
Active
Organization
IMAGEN & CHRYSTAL INC
Active
Other names
PV Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ENKHBAYAR TSERENDORJ L.AC. (CEO)
(310) 530-0500
Entity
Organization
Contact information
Practice address
26640 WESTERN AVE STE K2, HARBOR CITY, CA 90710-3600
(310) 530-0500
(310) 530-0501
Mailing address
26640 WESTERN AVE STE K2, HARBOR CITY, CA 90710-3600
(310) 530-0500
(310) 530-0501
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
AC11091
CA
Other
Enumeration date
01/30/2012
Last updated
01/30/2012
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