NPIMap

Organization Active NPI

Eastao Corp.

Doing business as Holistic Healing Source

  • Preferred Provider Organization
  • Alta Loma, CA
National Provider Identifier
1902082928
Registry record updated Jul 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
10000 Issued in CA
Legal business name
EASTAO CORP.
Doing business as
Holistic Healing Source
Practice address
9602 Baseline Rd
Alta Loma, CA 91701-5035
Phone
(909) 989-7000
Fax
(909) 989-7000
NPI assigned
Jan 21, 2008
Last updated
Jul 23, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2010

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

Authorized official

Name
Dr. Sahng Jae Yoo, L.AC.NPI 1740662659
Title
Manager
Phone
(909) 989-7000

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
Preferred Provider Organization 305R00000X 10000 CA Primary

Addresses

Primary practice location

9602 Baseline Rd
Alta Loma, CA 91701-5035

Mailing address

9602 Baseline Rd
Alta Loma, CA 91701-5035
Phone (909) 989-7000

Other identifiers 1

IdentifierTypeStateIssuer
AC10000OtherCAACUPUNCTURIST

Other names 1

  • Holistic Healing Source Doing business as

National Provider Directory

National Provider Directory

Locations

9602 Base Line Rd
Rancho Cucamonga, CA 91701
Phone (909) 989-7000

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1200873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279843200000",
    "number": "1902082928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9602 BASELINE RD",
            "city": "ALTA LOMA",
            "state": "CA",
            "postal_code": "917015035",
            "telephone_number": "909-989-7000",
            "fax_number": "909-989-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9602 BASELINE RD",
            "city": "ALTA LOMA",
            "state": "CA",
            "postal_code": "917015035",
            "telephone_number": "909-989-7000",
            "fax_number": "909-989-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTAO CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-21",
        "last_updated": "2010-07-23",
        "status": "A",
        "authorized_official_last_name": "YOO",
        "authorized_official_first_name": "SAHNG JAE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "909-989-7000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "L.AC."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": "10000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACUPUNCTURIST",
            "identifier": "AC10000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holistic Healing Source",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alta Loma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2010; 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.