=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477026169
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HU ACUPUNCTURE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/06/2019
-----------------------------------------------------
Last Update Date | 01/06/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 620 E WASHINGTON ST STE 110
-----------------------------------------------------
City | PETALUMA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94952-5911
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 707-782-9898
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 811 N CAPITOL AVE APT 3
-----------------------------------------------------
City | SAN JOSE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95133-1304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 707-782-9898
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | LYDIE XIN HU
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 707-782-9898
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171000000X
-----------------------------------------------------
Taxonomy Name | Military Health Care Provider
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------