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General NPI Number Information
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NPI Number | 1619411477
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Entity Type | Organization
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Legal Business Name | RELAX ACUPUNCTURE CLINIC
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Dates
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Enumeration Date | 12/14/2016
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Last Update Date | 12/14/2016
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Provider Practice Location Address
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Address Line | 608 E VALLEY BLVD STE D119
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City | SAN GABRIEL
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State | CA
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Zip | 91776-3594
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Country | US
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Telephone | 626-675-6299
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Fax |
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Provider Business Mailing Address
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Address Line | 501 MARIN ST STE 109
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-4265
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Country | US
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Telephone | 626-675-6299
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. ALAN YANG
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Credential | L.AC,
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Telephone | 626-675-6299
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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 10978
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License Number State | CA
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