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General NPI Number Information
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NPI Number | 1679138283
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Entity Type | Organization
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Legal Business Name | PRO ACUPUNCTURE AND HERBS INC
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Dates
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Enumeration Date | 05/08/2019
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Last Update Date | 05/08/2019
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Provider Practice Location Address
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Address Line | 3119 SAN GABRIEL BLVD STE D
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City | ROSEMEAD
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State | CA
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Zip | 91770-2545
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Country | US
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Telephone | 626-656-6599
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Fax |
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Provider Business Mailing Address
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Address Line | 3119 SAN GABRIEL BLVD STE D
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City | ROSEMEAD
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State | CA
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Zip | 91770-2545
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Country | US
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Telephone | 626-656-6599
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Fax |
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Authorized Official
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Title or Position | EMPLOYER
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Name | PROF. XIYAO YANG
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Credential | L.AC
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Telephone | 626-566-1298
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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 |
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License Number State |
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