Healthcare Provider Details
I. General information
NPI: 1609022052
Provider Name (Legal Business Name): ANKANG ACUPUNCTURE CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/15/2008
Last Update Date: 08/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
800 CALIFORNIA ST STE 120
MOUNTAIN VIEW CA
94041-2810
US
IV. Provider business mailing address
800 CALIFORNIA ST STE 120
MOUNTAIN VIEW CA
94041-2810
US
V. Phone/Fax
- Phone: 650-969-2034
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | 7989 |
| License Number State | CA |
VIII. Authorized Official
Name: MS.
LI
ZHANG
Title or Position: OWNER
Credential: LAC
Phone: 650-969-2034