Healthcare Provider Details

I. General information

NPI: 1265045470
Provider Name (Legal Business Name): ABUNDANT LIFE ACUPUNCTURE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2020
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 KIELY BLVD STE 255
SAN JOSE CA
95129-1354
US

IV. Provider business mailing address

7879 CREEKLINE DR
CUPERTINO CA
95014-4155
US

V. Phone/Fax

Practice location:
  • Phone: 408-876-7629
  • Fax:
Mailing address:
  • Phone: 408-876-7629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: WEIPING LEE
Title or Position: OWNER
Credential: L.AC
Phone: 408-876-7629