Healthcare Provider Details

I. General information

NPI: 1518519032
Provider Name (Legal Business Name): QIHUANG MEDICAL GROUP CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2019
Last Update Date: 07/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5150 GRAVES AVE STE 8D
SAN JOSE CA
95129-5008
US

IV. Provider business mailing address

5150 GRAVES AVE STE 8D
SAN JOSE CA
95129-5008
US

V. Phone/Fax

Practice location:
  • Phone: 765-413-6073
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ZHUYING HUANG
Title or Position: OWNER
Credential:
Phone: 765-413-6073