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General NPI Number Information
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NPI Number | 1528280229
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Entity Type | Individual
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Provider Name | DIANA IONG L.AC.
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Gender | Female
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1030 PIEDMONT RD SUITE E
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City | SAN JOSE
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State | CA
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Zip | 95132-2867
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Country | US
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Telephone | 408-483-0747
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Fax | 408-729-1808
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Provider Business Mailing Address
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Address Line | 680 WASHINGTON ST APT 1
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City | SANTA CLARA
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State | CA
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Zip | 95050-4937
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Country | US
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Telephone | 408-483-0747
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Fax | 408-423-9296
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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 | AC11760
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License Number State | CA
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