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General NPI Number Information
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NPI Number | 1760514798
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Entity Type | Organization
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Legal Business Name | MWM ACUPUNCTURE & HERBS, INC.
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1952 ABORN RD
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City | SAN JOSE
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State | CA
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Zip | 95121-1582
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Country | US
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Telephone | 408-221-1886
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Fax | 408-532-9280
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Provider Business Mailing Address
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Address Line | 1952 ABORN RD
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City | SAN JOSE
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State | CA
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Zip | 95121-1582
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Country | US
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Telephone | 408-221-1886
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Fax | 408-532-9280
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Authorized Official
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Title or Position | CEO
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Name | MR. WENMING MAO
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Credential | L.AC
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Telephone | 408-221-1886
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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 | 6693
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License Number State | CA
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