Provider Demographics
NPI:1265834816
Name:NATURES GRACE ACUPUNCTURE CENTER, INC.
Entity Type:Organization
Organization Name:NATURES GRACE ACUPUNCTURE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:QIANG
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:L AC
Authorized Official - Phone:951-296-1688
Mailing Address - Street 1:25470 MEDICAL CENTER DR
Mailing Address - Street 2:#104
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-4900
Mailing Address - Country:US
Mailing Address - Phone:951-296-1688
Mailing Address - Fax:951-696-3588
Practice Address - Street 1:25470 MEDICAL CENTER DR
Practice Address - Street 2:#104
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-4900
Practice Address - Country:US
Practice Address - Phone:951-296-1688
Practice Address - Fax:951-696-3588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-25
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5922302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization