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General NPI Number Information
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NPI Number | 1316480734
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Entity Type | Organization
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Legal Business Name | 360HEALTHCARE
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Dates
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Enumeration Date | 12/02/2016
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Last Update Date | 04/20/2020
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Provider Practice Location Address
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Address Line | 1765 SCOTT BLVD SUITE 101
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City | SANTA CLARA
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State | CA
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Zip | 95050-4138
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Country | US
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Telephone | 408-320-4020
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Fax |
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Provider Business Mailing Address
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Address Line | 1765 SCOTT BLVD SUITE 101
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City | SANTA CLARA
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State | CA
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Zip | 95050-4138
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Country | US
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Telephone | 408-320-4020
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | DONGJIAN WU
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Credential | L.AC
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Telephone | 408-320-4020
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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 9127
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC17622
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License Number State | CA
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