Healthcare Provider Details

I. General information

NPI: 1366759540
Provider Name (Legal Business Name): ALPHA ACUPUNCTURE & HERBS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2010
Last Update Date: 09/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 N MADISON AVE SUITE 710
PASADENA CA
91101-2035
US

IV. Provider business mailing address

316 SAN LUIS REY RD
ARCADIA CA
91007-3010
US

V. Phone/Fax

Practice location:
  • Phone: 626-844-2998
  • Fax: 626-844-2998
Mailing address:
  • Phone: 626-844-2998
  • Fax: 626-844-2998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOHN WONG
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: L.AC.
Phone: 626-844-2998