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General NPI Number Information
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NPI Number | 1902459449
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Entity Type | Organization
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Legal Business Name | KANG LE FAMILY ACUPUNCTURE & HERB, INC.
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Dates
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Enumeration Date | 07/23/2019
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Last Update Date | 07/23/2019
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Provider Practice Location Address
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Address Line | 585 N MOUNTAIN AVE STE C1
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City | UPLAND
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State | CA
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Zip | 91786-8516
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Country | US
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Telephone | 909-985-4372
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Fax | 909-985-0099
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Provider Business Mailing Address
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Address Line | 585 N MOUNTAIN AVE STE C1
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City | UPLAND
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State | CA
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Zip | 91786-8516
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Country | US
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Telephone | 909-985-4372
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Fax | 909-985-0099
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | CELINA CHAU
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Credential | L.AC
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Telephone | 909-985-4372
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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