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General NPI Number Information
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NPI Number | 1730682592
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Entity Type | Organization
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Legal Business Name | WENRU SUN ACUPUNCTURE CLINIC PROF. CORP.
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Dates
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Enumeration Date | 03/17/2018
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Last Update Date | 10/04/2023
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Provider Practice Location Address
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Address Line | 2040 FOREST AVE, #4
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City | SAN JOSE
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State | CA
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Zip | 95128
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Country | US
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Telephone | 408-599-6689
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Fax |
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Provider Business Mailing Address
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Address Line | 500 DOWNING AVE
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City | SAN JOSE
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State | CA
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Zip | 95128-3478
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. WENRU SUN
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Credential |
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Telephone | 408-599-6689
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | LAC
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License Number State | CA
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