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General NPI Number Information
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NPI Number | 1497977680
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Entity Type | Organization
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Legal Business Name | P-5 ACUPUNCTURE & HERBAL CENTER, INC.
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 17595 ALMAHURST ST #230
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City | CITY OF INDUSTRY
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State | CA
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Zip | 91748-1779
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Country | US
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Telephone | 162-683-9569
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Fax |
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Provider Business Mailing Address
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Address Line | 17595 ALMAHURST ST #230
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City | CITY OF INDUSTRY
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State | CA
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Zip | 91748-1779
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Country | US
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Telephone | 162-683-9569
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SOPHIA LI PENG
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Credential |
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Telephone | 16268395697
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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 | AC 7918
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License Number State | CA
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