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General NPI Number Information
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NPI Number | 1114580743
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Entity Type | Organization
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Legal Business Name | PROSPECT ACUPUNCTURE, INC
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Dates
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Enumeration Date | 04/18/2019
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Last Update Date | 04/18/2019
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Provider Practice Location Address
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Address Line | 18568 PROSPECT RD
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City | SARATOGA
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State | CA
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Zip | 95070-3646
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Country | US
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Telephone | 408-996-7358
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Fax |
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Provider Business Mailing Address
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Address Line | 19275 SAN MARCOS RD
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City | SARATOGA
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State | CA
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Zip | 95070-5677
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Country | US
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Telephone | 408-996-7358
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Fax | 866-890-9060
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Authorized Official
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Title or Position | CEO
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Name | DR. YUNYONG LU
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Credential | DOAM
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Telephone | 408-996-7358
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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 |
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License Number State |
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