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General NPI Number Information
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NPI Number | 1154780419
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Entity Type | Organization
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Legal Business Name | PINE SPRING ACUPUNCTURE CLINIC PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 02/15/2016
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Last Update Date | 02/15/2016
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Provider Practice Location Address
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Address Line | 1580 OAKLAND RD SUITE C100
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City | SAN JOSE
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State | CA
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Zip | 95131-2440
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Country | US
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Telephone | 408-657-0889
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Fax | 888-607-0866
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Provider Business Mailing Address
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Address Line | 1580 OAKLAND RD SUITE C100
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City | SAN JOSE
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State | CA
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Zip | 95131-2440
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Country | US
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Telephone | 408-657-0889
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Fax | 888-607-0866
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHUNG CHAO HUANG
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Credential |
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Telephone | 949-300-3233
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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 11915
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License Number State | CA
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