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General NPI Number Information
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NPI Number | 1043846702
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Entity Type | Organization
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Legal Business Name | HARMONY HOLISTIC WELLNESS CENTER LLC
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Dates
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Enumeration Date | 03/13/2020
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Last Update Date | 03/13/2020
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Provider Practice Location Address
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Address Line | 2179 TULLY RD
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City | SAN JOSE
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State | CA
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Zip | 95122-1346
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Country | US
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Telephone | 408-426-4135
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Fax |
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Provider Business Mailing Address
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Address Line | 2179 TULLY RD
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City | SAN JOSE
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State | CA
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Zip | 95122-1346
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Country | US
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Telephone | 408-426-4135
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. JAMES KANG SONG
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Credential | LA.C
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Telephone | 213-272-3004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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