Healthcare Provider Details

I. General information

NPI: 1699930669
Provider Name (Legal Business Name): TINGSHU HUANG L.A.C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2008
Last Update Date: 07/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

683 INDIAN HILL BLVD
POMONA CA
91767-5303
US

IV. Provider business mailing address

683 INDIAN HILL BLVD
POMONA CA
91767-5303
US

V. Phone/Fax

Practice location:
  • Phone: 909-620-7884
  • Fax: 909-469-2467
Mailing address:
  • Phone: 909-620-7884
  • Fax: 909-469-2467

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC 8827
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: