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General NPI Number Information
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NPI Number | 1316395577
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Entity Type | Organization
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Legal Business Name | SERENITY VALLEY ACUPUNCTURE CENTER, INC.
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Dates
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Enumeration Date | 05/28/2016
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Last Update Date | 05/28/2016
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Provider Practice Location Address
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Address Line | 182 S MAIN ST
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City | MILPITAS
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State | CA
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Zip | 95035-5313
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Country | US
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Telephone | 408-878-5111
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Fax |
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Provider Business Mailing Address
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Address Line | 880 WILLOW ST APT 21
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City | SAN JOSE
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State | CA
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Zip | 95125-2338
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Country | US
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Telephone | 408-878-5111
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Fax |
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Authorized Official
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Title or Position | PRESIDENT / CEO
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Name | HSUN LEE
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Credential | A.C.
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Telephone | 408-878-5111
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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 16654
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License Number State | CA
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