Healthcare Provider Details
I. General information
NPI: 1851072011
Provider Name (Legal Business Name): HUANG ACUPUNCTURE & HERB INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/28/2023
Last Update Date: 07/28/2023
Certification Date: 07/28/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14351 RED HILL AVE STE C
TUSTIN CA
92780-6271
US
IV. Provider business mailing address
14351 RED HILL AVE STE C
TUSTIN CA
92780-6271
US
V. Phone/Fax
- Phone: 714-580-3808
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
GING HAO
HUANG
Title or Position: PRESIDENT & CEO
Credential: LAC
Phone: 714-580-3808