Healthcare Provider Details

I. General information

NPI: 1295924264
Provider Name (Legal Business Name): CHINESE MEDICINE WORKS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2007
Last Update Date: 10/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2824 CAMINO DOS RIOS
NEWBURY PARK CA
91320-1137
US

IV. Provider business mailing address

2824 CAMINO DOS RIOS
NEWBURY PARK CA
91320-1137
US

V. Phone/Fax

Practice location:
  • Phone: 805-498-8585
  • Fax:
Mailing address:
  • Phone: 805-498-8585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number11574
License Number State

VIII. Authorized Official

Name: XIAOYANG SHEN
Title or Position: MANAGER
Credential:
Phone: 805-498-8585