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General NPI Number Information
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NPI Number | 1003162447
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Entity Type | Organization
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Legal Business Name | EDEN NATURAL HEALING INSTITUTE, LLC
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Dates
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Enumeration Date | 08/02/2012
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Last Update Date | 08/02/2012
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Provider Practice Location Address
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Address Line | 20370 TOWN CENTER LN STE B202
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City | CUPERTINO
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State | CA
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Zip | 95014-3213
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Country | US
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Telephone | 408-996-0888
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Fax | 408-973-9874
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Provider Business Mailing Address
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Address Line | 20370 TOWN CENTER LN STE B202
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City | CUPERTINO
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State | CA
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Zip | 95014-3213
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Country | US
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Telephone | 408-996-0888
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Fax | 408-973-9874
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Authorized Official
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Title or Position | MANAGER
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Name | DR. STEPHEN LIN
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Credential | PH.D.
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Telephone | 408-996-0888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | AC10610
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License Number State | CA
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