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General NPI Number Information
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NPI Number | 1942733613
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Entity Type | Organization
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Legal Business Name | GREEN ACUPUNCTURE, PROF. CORP.
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Dates
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Enumeration Date | 04/09/2017
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Last Update Date | 04/09/2017
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Provider Practice Location Address
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Address Line | 13788 ROSWELL AVE #138
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City | CHINO
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State | CA
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Zip | 91710-1409
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Country | US
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Telephone | 626-780-5698
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Fax |
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Provider Business Mailing Address
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Address Line | 13788 ROSWELL AVE #138
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City | CHINO
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State | CA
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Zip | 91710-1409
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Country | US
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Telephone | 626-780-5698
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JUNG LIEN YANG
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Credential | M.D.
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Telephone | 626-780-5698
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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 | AC17449
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC17447
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License Number State | CA
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