Healthcare Provider Details

I. General information

NPI: 1477026169
Provider Name (Legal Business Name): HU ACUPUNCTURE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2019
Last Update Date: 01/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 E WASHINGTON ST STE 110
PETALUMA CA
94952-5911
US

IV. Provider business mailing address

811 N CAPITOL AVE APT 3
SAN JOSE CA
95133-1304
US

V. Phone/Fax

Practice location:
  • Phone: 707-782-9898
  • Fax:
Mailing address:
  • Phone: 707-782-9898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State

VIII. Authorized Official

Name: LYDIE XIN HU
Title or Position: CEO
Credential:
Phone: 707-782-9898