Healthcare Provider Details

I. General information

NPI: 1023704673
Provider Name (Legal Business Name): HSIANG CHUN KUO L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2023
Last Update Date: 04/17/2023
Certification Date: 04/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2236 SMOKE TREE LN
ONTARIO CA
91762-6163
US

IV. Provider business mailing address

2236 SMOKE TREE LN
ONTARIO CA
91762-6163
US

V. Phone/Fax

Practice location:
  • Phone: 909-226-8799
  • Fax:
Mailing address:
  • Phone: 909-226-8799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC7520
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: