Provider Demographics
NPI:1114580743
Name:PROSPECT ACUPUNCTURE, INC
Entity Type:Organization
Organization Name:PROSPECT ACUPUNCTURE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:YUNYONG
Authorized Official - Middle Name:
Authorized Official - Last Name:LU
Authorized Official - Suffix:
Authorized Official - Credentials:DOAM
Authorized Official - Phone:408-996-7358
Mailing Address - Street 1:19275 SAN MARCOS RD
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-5677
Mailing Address - Country:US
Mailing Address - Phone:408-996-7358
Mailing Address - Fax:866-890-9060
Practice Address - Street 1:18568 PROSPECT RD
Practice Address - Street 2:
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070-3646
Practice Address - Country:US
Practice Address - Phone:408-996-7358
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center