Healthcare Provider Details
I. General information
NPI: 1437466901
Provider Name (Legal Business Name): RADIANT CHIROPRACTIC AND ACUPUNCTURE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/07/2010
Last Update Date: 02/01/2024
Certification Date: 07/16/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
525 W. REMINGTON DR. STE 120
SUNNYVALE CA
94087
US
IV. Provider business mailing address
525 W. REMINGTON DR. STE 120
SUNNYVALE CA
94087
US
V. Phone/Fax
- Phone: 408-749-1558
- Fax: 408-749-0928
- Phone: 408-749-1558
- Fax: 408-749-0928
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | DC 29274 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | AC 12302 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
TONY
M.
WOO
Title or Position: OWNER
Credential: DC, LAC
Phone: 408-749-1558