Healthcare Provider Details

I. General information

NPI: 1740767706
Provider Name (Legal Business Name): GEORGE HWANG ACUPUNCTURE CLINIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2018
Last Update Date: 09/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10430 S DE ANZA BLVD STE 195
CUPERTINO CA
95014-3006
US

IV. Provider business mailing address

6640 CANTERBURY CT
SAN JOSE CA
95129-3870
US

V. Phone/Fax

Practice location:
  • Phone: 408-454-8267
  • Fax: 408-693-3744
Mailing address:
  • Phone: 408-454-8267
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number15898
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number15898
License Number StateCA

VIII. Authorized Official

Name: DR. CHENG-CHIN HWANG
Title or Position: PRESIDENT
Credential: PHD.
Phone: 408-221-5796