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General NPI Number Information
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NPI Number | 1316624869
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Entity Type | Organization
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Legal Business Name | DE-YI CHINESE HERB & ACUPUNCTURE CLINIC
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Dates
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Enumeration Date | 06/28/2023
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Last Update Date | 06/28/2023
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Provider Practice Location Address
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Address Line | 9368 VALLEY BLVD 103
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City | ROSEMEAD
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State | CA
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Zip | 91770-1990
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Country | US
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Telephone | 323-633-0398
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Fax | 626-380-4069
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Provider Business Mailing Address
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Address Line | 9368 VALLEY BLVD 103
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City | ROSEMEAD
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State | CA
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Zip | 91770-1990
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Country | US
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Telephone | 323-633-0398
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Fax | 626-380-4069
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Authorized Official
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Title or Position | CEO
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Name | PU POLLY WANG
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Credential |
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Telephone | 323-633-0398
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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 |
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License Number State |
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