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General NPI Number Information
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NPI Number | 1366759540
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Entity Type | Organization
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Legal Business Name | ALPHA ACUPUNCTURE & HERBS, INC.
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Dates
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Enumeration Date | 09/09/2010
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Last Update Date | 09/09/2010
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Provider Practice Location Address
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Address Line | 65 N MADISON AVE SUITE 710
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City | PASADENA
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State | CA
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Zip | 91101-2035
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Country | US
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Telephone | 626-844-2998
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Fax | 626-844-2998
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Provider Business Mailing Address
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Address Line | 316 SAN LUIS REY RD
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City | ARCADIA
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State | CA
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Zip | 91007-3010
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Country | US
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Telephone | 626-844-2998
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Fax | 626-844-2998
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | JOHN WONG
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Credential | L.AC.
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Telephone | 626-844-2998
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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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