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General NPI Number Information
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NPI Number | 1982092599
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Entity Type | Organization
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Legal Business Name | CHINESE MEDICINE CENTER
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Dates
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Enumeration Date | 01/05/2015
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Last Update Date | 01/05/2015
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Provider Practice Location Address
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Address Line | 37982 FREMONT BLVD APT 105
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City | FREMONT
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State | CA
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Zip | 94536-5029
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Country | US
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Telephone | 408-667-3298
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Fax |
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Provider Business Mailing Address
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Address Line | 37200 MEADOWBROOK CMN APT 105
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City | FREMONT
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State | CA
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Zip | 94536-3677
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Country | US
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Telephone | 408-667-3298
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | CHIA CHI WANG
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Credential |
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Telephone | 408-667-3298
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | AC-14592
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License Number State | CA
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