Healthcare Provider Details

I. General information

NPI: 1205154192
Provider Name (Legal Business Name): WEI HUANG ACUPUNCTURE/HERB MED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2010
Last Update Date: 05/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6430 W SUNSET BLVD SUITE 707
LOS ANGELES CA
90028-7901
US

IV. Provider business mailing address

PO BOX 974
TWENTYNINE PALMS CA
92277-0960
US

V. Phone/Fax

Practice location:
  • Phone: 760-881-6552
  • Fax: 888-470-1054
Mailing address:
  • Phone: 760-881-6552
  • Fax: 888-470-1054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number9939
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: