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General NPI Number Information
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NPI Number | 1386870764
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Entity Type | Organization
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Legal Business Name | SHANGRI-LA WELLNESS CENTER
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Dates
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Enumeration Date | 05/30/2009
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Last Update Date | 05/30/2009
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Provider Practice Location Address
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Address Line | 131 E TAYLOR ST
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City | SAN JOSE
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State | CA
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Zip | 95112-5032
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Country | US
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Telephone | 408-287-7888
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Fax |
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Provider Business Mailing Address
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Address Line | 131 E TAYLOR ST
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City | SAN JOSE
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State | CA
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Zip | 95112-5032
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Country | US
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Telephone | 408-287-7888
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HUBERT H HUANG
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Credential | PH.D.
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Telephone | 650-283-8382
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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 | 6763972771
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License Number State | CA
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