Healthcare Provider Details

I. General information

NPI: 1326683020
Provider Name (Legal Business Name): WANHE ACUPUNCTURE CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2019
Last Update Date: 11/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 LANDESS AVE
MILPITAS CA
95035-6901
US

IV. Provider business mailing address

1555 LANDESS AVE
MILPITAS CA
95035-6901
US

V. Phone/Fax

Practice location:
  • Phone: 408-627-9295
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: FEIDU GE LU
Title or Position: OWNER
Credential:
Phone: 408-930-1585