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General NPI Number Information
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NPI Number | 1396192910
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Entity Type | Individual
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Provider Name | HUNG CHENG KUO LAC
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Gender | Male
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Dates
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Enumeration Date | 05/24/2016
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Last Update Date | 10/06/2016
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Provider Practice Location Address
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Address Line | 3862 SMITH ST
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City | UNION CITY
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State | CA
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Zip | 94587-2614
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Country | US
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Telephone | 510-219-3806
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Fax |
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Provider Business Mailing Address
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Address Line | 2619 COPA DEL ORO DR
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City | UNION CITY
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State | CA
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Zip | 94587-3175
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Country | US
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Telephone | 510-219-3806
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | AC17054
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License Number State | CA
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