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General NPI Number Information
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NPI Number | 1831382464
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Entity Type | Organization
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Legal Business Name | WARDAH 1, INC
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Dates
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Enumeration Date | 08/27/2007
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Last Update Date | 08/27/2007
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Provider Practice Location Address
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Address Line | 529 E VALLEY BLVD SUITE #188-A
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City | SAN GABRIEL
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State | CA
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Zip | 91776-3668
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Country | US
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Telephone | 626-572-5191
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Fax |
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Provider Business Mailing Address
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Address Line | 529 E VALLEY BLVD SUITE #188-A
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City | SAN GABRIEL
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State | CA
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Zip | 91776-3668
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Country | US
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Telephone | 626-572-5191
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURE DOCTOR
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Name | SHENG BIN YANG
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Credential | L.AC
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Telephone | 626-572-5191
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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 | AC8387
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License Number State | CA
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