Provider Demographics
NPI:1174853337
Name:T & G 2010 LLC
Entity Type:Organization
Organization Name:T & G 2010 LLC
Other - Org Name:QIANFANG ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER & MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAOHSUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-230-2282
Mailing Address - Street 1:120 E REMINGTON DR APT 614
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-2629
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20279 STEVENS CREEK BLVD
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-2258
Practice Address - Country:US
Practice Address - Phone:408-230-2282
Practice Address - Fax:408-736-3952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-11
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALAC11204302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization