Provider Demographics
NPI:1447088166
Name:LORE OF CHINESE MEDICINE INC
Entity type:Organization
Organization Name:LORE OF CHINESE MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMSON
Authorized Official - Middle Name:H
Authorized Official - Last Name:CHEUNG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, DAOM, LAC,
Authorized Official - Phone:408-831-1038
Mailing Address - Street 1:100 OCONNOR DR STE 27
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-1655
Mailing Address - Country:US
Mailing Address - Phone:408-831-1038
Mailing Address - Fax:408-998-7215
Practice Address - Street 1:100 OCONNOR DR STE 27
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1655
Practice Address - Country:US
Practice Address - Phone:408-831-1038
Practice Address - Fax:408-998-7215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty