Healthcare Provider Details

I. General information

NPI: 1326234147
Provider Name (Legal Business Name): NATIONAL HEALTHCARE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2007
Last Update Date: 09/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2019 GALISTEO ST STE C1
SANTA FE NM
87505-2168
US

IV. Provider business mailing address

2019 GALISTEO ST STE C1
SANTA FE NM
87505-2168
US

V. Phone/Fax

Practice location:
  • Phone: 505-986-0542
  • Fax: 505-986-8984
Mailing address:
  • Phone: 505-986-0542
  • Fax: 505-986-8984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number263
License Number StateNM

VIII. Authorized Official

Name: JASON JISHUN HAO
Title or Position: PRESIDENT
Credential: DOM
Phone: 505-986-0542