Healthcare Provider Details
I. General information
NPI: 1912836453
Provider Name (Legal Business Name): PANDA ACUPUNCTURE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
30313 CANWOOD ST STE 23
AGOURA HILLS CA
91301-2034
US
IV. Provider business mailing address
30313 CANWOOD ST STE 23
AGOURA HILLS CA
91301-2034
US
V. Phone/Fax
- Phone: 818-651-9899
- Fax:
- Phone: 818-651-9899
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TAIPING
GAO
Title or Position: CEO
Credential:
Phone: 626-999-2226