Provider Demographics
NPI:1043884273
Name:WHITEWATER UNIVERSITY OF CALIFORNIA ACUPUNCTURE CLINIC
Entity Type:Organization
Organization Name:WHITEWATER UNIVERSITY OF CALIFORNIA ACUPUNCTURE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF THE CLINIC
Authorized Official - Prefix:
Authorized Official - First Name:YU
Authorized Official - Middle Name:
Authorized Official - Last Name:GUO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:669-298-7989
Mailing Address - Street 1:3150 ALMADEN EXPY STE 111
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95118-1217
Mailing Address - Country:US
Mailing Address - Phone:669-298-7989
Mailing Address - Fax:
Practice Address - Street 1:3150 ALMADEN EXPY STE 111
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95118-1217
Practice Address - Country:US
Practice Address - Phone:669-298-7989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-13
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty