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General NPI Number Information
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NPI Number | 1942588090
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Entity Type | Organization
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Legal Business Name | GLDEN OASIS HEALTH
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Dates
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Enumeration Date | 07/22/2011
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Last Update Date | 07/22/2011
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Provider Practice Location Address
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Address Line | 965 S BASCOM AVE
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City | SAN JOSE
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State | CA
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Zip | 95128-3503
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Country | US
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Telephone | 510-828-6457
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Fax |
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Provider Business Mailing Address
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Address Line | 965 S BASCOM AVE
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City | SAN JOSE
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State | CA
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Zip | 95128-3503
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LI BAI
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Credential |
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Telephone | 510-828-6457
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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 | AC11955
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License Number State | CA
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