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General NPI Number Information
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NPI Number | 1104351444
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Entity Type | Organization
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Legal Business Name | FLOURISHING QI HEALTHCARE INC
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Dates
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Enumeration Date | 04/24/2017
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Last Update Date | 04/24/2017
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Provider Practice Location Address
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Address Line | 1101 S WINCHESTER BLVD
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City | SAN JOSE
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State | CA
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Zip | 95128-3901
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Country | US
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Telephone | 408-618-1415
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Fax | 628-232-2468
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Provider Business Mailing Address
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Address Line | 503 1/2 UNIVERSITY AVE
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City | LOS GATOS
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State | CA
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Zip | 95032-4459
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Country | US
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Telephone | 408-618-1415
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Fax | 628-232-2468
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Authorized Official
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Title or Position | CEO
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Name | WEIMING HUANG
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Credential |
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Telephone | 408-618-1415
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | AC16380
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License Number State | CA
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