Healthcare Provider Details

I. General information

NPI: 1205317013
Provider Name (Legal Business Name): PAK'S NATURAL HEALING CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2018
Last Update Date: 08/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 COLBY ST STE 203A
BERKELEY CA
94705-2058
US

IV. Provider business mailing address

3000 COLBY ST STE 203A
BERKELEY CA
94705-2058
US

V. Phone/Fax

Practice location:
  • Phone: 510-845-8477
  • Fax: 866-929-7361
Mailing address:
  • Phone: 510-845-8477
  • Fax: 866-929-7361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC7158
License Number StateCA

VIII. Authorized Official

Name: DR. KEI HANG PAK
Title or Position: DR
Credential: L.AC, DAOM
Phone: 510-845-8477