NPIMap

Organization Active NPI

Living Well Medical Clinic

  • Acupuncturist
  • Walnut, CA
National Provider Identifier
1780121657
Registry record updated Jan 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC17127 Issued in CA
Legal business name
LIVING WELL MEDICAL CLINIC
Practice address
21102 Northview Dr
Walnut, CA 91789-2022
Phone
(909) 979-7643
NPI assigned
Jan 30, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2017

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

Authorized official

Name
Trina ChangNPI 1457702961
Title
Owner
Phone
(909) 979-7643

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193400000X SINGLE SPECIALTY GROUP 171100000X AC17127 CA Primary

Addresses

Primary practice location

21102 Northview Dr
Walnut, CA 91789-2022

Mailing address

21102 Northview Dr
Walnut, CA 91789-2022
Phone (909) 979-7643

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1485734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485734400000",
    "number": "1780121657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21102 NORTHVIEW DR",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917892022",
            "telephone_number": "909-979-7643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21102 NORTHVIEW DR",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917892022",
            "telephone_number": "909-979-7643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WELL MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-30",
        "last_updated": "2017-01-30",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "TRINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-979-7643"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC17127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2017; 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.