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General NPI Number Information
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NPI Number | 1740743566
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Entity Type | Organization
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Legal Business Name | LING ZHEN TANG LLC
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Dates
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Enumeration Date | 04/09/2019
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Last Update Date | 04/09/2019
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Provider Practice Location Address
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Address Line | 5145 STEVENS CREEK BLVD STE 110
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City | SANTA CLARA
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State | CA
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Zip | 95051-6667
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Country | US
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Telephone | 408-490-4859
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Fax |
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Provider Business Mailing Address
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Address Line | 5145 STEVENS CREEK BLVD STE 110
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City | SANTA CLARA
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State | CA
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Zip | 95051-6667
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Country | US
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Telephone | 408-490-4859
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | XINGQUAN DAI
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Credential |
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Telephone | 415-812-7395
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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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