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General NPI Number Information
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NPI Number | 1053859991
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Entity Type | Organization
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Legal Business Name | HEALING LIGHT FAMILY ACUPUNCTURE CORP.
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Dates
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Enumeration Date | 02/10/2017
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Last Update Date | 02/10/2017
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Provider Practice Location Address
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Address Line | 18430 BROOKHURST ST STE 102
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-6726
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Country | US
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Telephone | 949-257-7622
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Fax |
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Provider Business Mailing Address
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Address Line | 18430 BROOKHURST ST STE 102
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-6726
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Country | US
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Telephone | 949-257-7622
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Fax |
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Authorized Official
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Title or Position | CFO, SECRETARY
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Name | MUKUNDA SINGH
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Credential |
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Telephone | 949-257-7622
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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 | AC 13194
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License Number State | CA
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