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General NPI Number Information
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NPI Number | 1477019198
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Entity Type | Organization
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Legal Business Name | CEDAR EASTERN TRADITIONAL HEALTHCARE INC
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Dates
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Enumeration Date | 02/19/2019
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Last Update Date | 02/19/2019
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Provider Practice Location Address
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Address Line | 5131 MOORPARK AVE
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City | SAN JOSE
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State | CA
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Zip | 95129-2100
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Country | US
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Telephone | 408-835-4941
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Fax |
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Provider Business Mailing Address
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Address Line | 1101 POINCIANA DR
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City | SUNNYVALE
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State | CA
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Zip | 94086-8324
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Country | US
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Telephone | 408-835-4941
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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 JIANG
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Credential | ACUPUNCTURIST
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Telephone | 408-835-4941
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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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