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General NPI Number Information
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NPI Number | 1558807529
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Entity Type | Organization
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Legal Business Name | EVERGLORY ACUPUNCTURE CLINIC & INSTITUTE INC
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Dates
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Enumeration Date | 01/13/2017
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Last Update Date | 01/13/2017
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Provider Practice Location Address
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Address Line | 9143 VALLEY BLVD STE 201B
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City | ROSEMEAD
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State | CA
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Zip | 91770-1992
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Country | US
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Telephone | 626-280-9268
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Fax |
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Provider Business Mailing Address
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Address Line | 9143 VALLEY BLVD #201B
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City | ROSEMEAD
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State | CA
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Zip | 91770-1919
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Country | US
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Telephone | 626-280-9268
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AI PING SUN
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Credential |
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Telephone | 626-280-9268
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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 | AC4643
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License Number State | CA
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