Healthcare Provider Details
I. General information
NPI: 1336427640
Provider Name (Legal Business Name): HOA MAI ACUPUNCTURE & CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/03/2011
Last Update Date: 08/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10131 WESTMINSTER AVE SUITE 208
GARDEN GROVE CA
92843-4752
US
IV. Provider business mailing address
10131 WESTMINSTER AVE SUITE 208
GARDEN GROVE CA
92843-4752
US
V. Phone/Fax
- Phone: 714-537-0988
- Fax: 714-537-0988
- Phone: 714-537-0988
- Fax: 714-537-0988
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | AC13167 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | DC24420 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
MAI
THI
HUYNH
Title or Position: OWNER/DOCTOR
Credential: DC
Phone: 714-717-2201