Healthcare Provider Details

I. General information

NPI: 1144734021
Provider Name (Legal Business Name): YZ ACUPUNCTURE AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2017
Last Update Date: 11/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 S HUDSON AVE STE 4
PASADENA CA
91101-2614
US

IV. Provider business mailing address

133 S HUDSON AVE STE 4
PASADENA CA
91101-2614
US

V. Phone/Fax

Practice location:
  • Phone: 626-449-5511
  • Fax:
Mailing address:
  • Phone: 626-449-5511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number14272
License Number StateCA

VIII. Authorized Official

Name: MS. SARAH ADCOCK
Title or Position: CEO
Credential:
Phone: 626-449-5511