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General NPI Number Information
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NPI Number | 1619481371
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Entity Type | Organization
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Legal Business Name | DAHARA WELLNESS ACUPUNCTURE, INC.
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Dates
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Enumeration Date | 11/16/2017
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Last Update Date | 11/16/2017
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Provider Practice Location Address
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Address Line | 3216 EL CAMINO REAL STE 9
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City | SANTA CLARA
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State | CA
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Zip | 95051-2871
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Country | US
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Telephone | 408-982-3002
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Fax | 408-642-1768
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Provider Business Mailing Address
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Address Line | 3216 EL CAMINO REAL STE 9
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City | SANTA CLARA
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State | CA
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Zip | 95051-2871
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Country | US
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Telephone | 408-982-3002
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Fax | 408-642-1768
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Authorized Official
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Title or Position | CEO
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Name | YOUNG CHUN YOU
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Credential | L.AC.
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Telephone | 408-982-3002
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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 | AC15893
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License Number State | CA
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