Healthcare Provider Details

I. General information

NPI: 1013847698
Provider Name (Legal Business Name): RESTORE ACUPUNCTURE A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2026
Last Update Date: 05/23/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4463 STONERIDGE DR STE C
PLEASANTON CA
94588-8402
US

IV. Provider business mailing address

3623 CAMERON AVE
PLEASANTON CA
94588-2617
US

V. Phone/Fax

Practice location:
  • Phone: 662-989-1109
  • Fax:
Mailing address:
  • Phone: 662-989-1109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: XIN WANG
Title or Position: PRESIDENT
Credential: LAC
Phone: 662-989-1109