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General NPI Number Information
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NPI Number | 1356893200
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Entity Type | Organization
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Legal Business Name | TRANSFORMATION ACUPUNCTURE
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Dates
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Enumeration Date | 10/26/2016
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Last Update Date | 10/26/2016
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Provider Practice Location Address
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Address Line | 320 10TH ST SUITE 228
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City | OAKLAND
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State | CA
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Zip | 94607-4269
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Country | US
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Telephone | 919-721-9811
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Fax |
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Provider Business Mailing Address
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Address Line | 283 13TH ST APT 802
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City | OAKLAND
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State | CA
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Zip | 94612-3909
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Country | US
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Telephone | 919-721-9811
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HONG CHEN
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Credential | L.AC.
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Telephone | 919-721-9811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | AC 17115
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License Number State | CA
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