Imagen & Chrystal Inc

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

AC11091 Issued in CA

Legal business name

IMAGEN & CHRYSTAL INC

Doing business as

PV Wellness Center

Practice address

26640 Western Ave Ste K2
Harbor City, CA 90710-3600

Phone

(310) 530-0500

Fax

(310) 530-0501

NPI assigned

Jan 30, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Enkhbayar Tserendorj, L.AC.

Title

Ceo

Phone

(310) 530-0500

Specialties & licenses 1

Addresses

Other names 1

• PV Wellness Center Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1327881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327881600000",
    "number": "1225300775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26640 WESTERN AVE STE K2",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "907103600",
            "telephone_number": "310-530-0500",
            "fax_number": "310-530-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26640 WESTERN AVE STE K2",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "907103600",
            "telephone_number": "310-530-0500",
            "fax_number": "310-530-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGEN & CHRYSTAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-30",
        "last_updated": "2012-01-30",
        "status": "A",
        "authorized_official_last_name": "TSERENDORJ",
        "authorized_official_first_name": "ENKHBAYAR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-530-0500",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "L.AC."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "CA",
            "license": "AC11091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PV Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah Eunjoo Hwang, PHARM.D.
• Myra Ichikawa, RDN
• Almace Ignacio, OTR
• Kim I Ikemoto, OD
• Nicolette P Im
• Ryokei K. Imai, MD
• Tracy May Imley, MD
• In Motion Physical Therapy and Rehab, Inc
• Sharon H Inada, AUD
• Ehigimetor Inegbenoise

• Health Service Clinic/Center in Harbor City, CA
• Providers in Harbor City, CA by specialty
• Health Service Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.