Healthcare Provider Details

I. General information

NPI: 1225681182
Provider Name (Legal Business Name): QIHUANG HERBS GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2019
Last Update Date: 07/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4028 GRAND AVE STE C
CHINO CA
91710-5486
US

IV. Provider business mailing address

4028 GRAND AVE STE C
CHINO CA
91710-5486
US

V. Phone/Fax

Practice location:
  • Phone: 909-517-1577
  • Fax:
Mailing address:
  • Phone: 909-517-1577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: HONG LI
Title or Position: ACUPUNCTURISTS
Credential:
Phone: 909-517-1577