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General NPI Number Information
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NPI Number | 1780097329
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Entity Type | Organization
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Legal Business Name | VITALITY HEALTH CENTER,INC
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Dates
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Enumeration Date | 06/10/2014
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Last Update Date | 06/10/2014
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Provider Practice Location Address
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Address Line | 2464 W EL CAMINO REAL STE B
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-1425
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Country | US
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Telephone | 650-766-8718
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Fax |
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Provider Business Mailing Address
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Address Line | 2464 W EL CAMINO REAL STE B
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-1425
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Country | US
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Telephone | 650-766-8718
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | MS. YOSHIE ANTO SR.
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Credential | DAOM
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Telephone | 650-766-8718
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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 | 13263
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License Number State | CA
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