Healthcare Provider Details

I. General information

NPI: 1528313293
Provider Name (Legal Business Name): MEI HUANG L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2012
Last Update Date: 07/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 B ST SUITE B
DAVIS CA
95616-4575
US

IV. Provider business mailing address

200 B STREET SUITE B
DAVIS CA
95616
US

V. Phone/Fax

Practice location:
  • Phone: 530-753-3096
  • Fax:
Mailing address:
  • Phone: 530-753-3096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC12310
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: