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General NPI Number Information
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NPI Number | 1821561804
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Entity Type | Organization
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Legal Business Name | 66 ACUPUNCTURE & HERBS, INC.
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Dates
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Enumeration Date | 01/02/2019
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Last Update Date | 01/02/2019
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Provider Practice Location Address
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Address Line | 17595 ALMAHURST ST STE 230
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City | CITY OF INDUSTRY
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State | CA
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Zip | 91748-1799
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Country | US
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Telephone | 626-839-5697
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Fax | 626-839-5697
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Provider Business Mailing Address
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Address Line | 17595 ALMAHURST ST STE 230
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City | CITY OF INDUSTRY
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State | CA
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Zip | 91748-1799
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Country | US
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Telephone | 626-839-5697
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Fax | 626-839-5697
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | BOB WANG
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Credential | L.AC.
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Telephone | 626-839-5697
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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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