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General NPI Number Information
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NPI Number | 1477952596
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Entity Type | Organization
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Legal Business Name | HEALTHY LIFE ACUPUNCTURE & HERBAL MEDICINE CENTER ,INC
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Dates
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Enumeration Date | 08/14/2014
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Last Update Date | 08/14/2014
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Provider Practice Location Address
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Address Line | 14471 CHAMBERS RD STE 105
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City | TUSTIN
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State | CA
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Zip | 92780-6969
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Country | US
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Telephone | 626-373-6037
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Fax |
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Provider Business Mailing Address
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Address Line | 14471 CHAMBERS RD STE 105
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City | TUSTIN
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State | CA
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Zip | 92780-6969
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Country | US
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Telephone | 626-373-6037
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Fax |
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | XUEWEN ZHANG
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Credential | L.AC.,PH.D
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Telephone | 626-373-6037
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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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