Healthcare Provider Details

I. General information

NPI: 1972823680
Provider Name (Legal Business Name): PAK'S NATURAL HEALING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2010
Last Update Date: 06/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2435 WEBSTER ST STE F
BERKELEY CA
94705-2050
US

IV. Provider business mailing address

2435 WEBSTER ST STE F
BERKELEY CA
94705-2050
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

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