Provider Demographics
NPI:1053856484
Name:DO ACUPUNCTURE HERBS CORP
Entity Type:Organization
Organization Name:DO ACUPUNCTURE HERBS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NGOC
Authorized Official - Middle Name:
Authorized Official - Last Name:DO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:669-888-6979
Mailing Address - Street 1:979 STORY RD
Mailing Address - Street 2:UNIT 7024
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95122-4602
Mailing Address - Country:US
Mailing Address - Phone:669-888-6979
Mailing Address - Fax:
Practice Address - Street 1:979 STORY RD
Practice Address - Street 2:UNIT 7024
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122-4602
Practice Address - Country:US
Practice Address - Phone:669-888-6979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-20
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 16757171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty