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General NPI Number Information
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NPI Number | 1770898512
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Entity Type | Organization
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Legal Business Name | GRACE ACUPUNCTURE HEALING CENTER
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Dates
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Enumeration Date | 08/17/2010
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Last Update Date | 08/17/2010
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Provider Practice Location Address
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Address Line | 1848 SARATOGA AVE STE 7
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City | SARATOGA
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State | CA
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Zip | 95070-4160
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Country | US
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Telephone | 408-364-0968
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Fax | 408-364-0968
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Provider Business Mailing Address
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Address Line | 1458 MILLER AVE
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City | SAN JOSE
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State | CA
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Zip | 95129-3937
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Country | US
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Telephone | 408-364-0968
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Fax | 408-364-0968
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Authorized Official
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Title or Position | L.A.C
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Name | MRS. YING LI
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Credential |
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Telephone | 408-364-0968
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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 | AC5307
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License Number State | CA
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