Provider Demographics
NPI:1346881489
Name:HERBAL LANDS INC
Entity Type:Organization
Organization Name:HERBAL LANDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAKARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MADHAVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-909-0325
Mailing Address - Street 1:2485 AUTUMNVALE DR, STE D
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95131
Mailing Address - Country:US
Mailing Address - Phone:408-909-0325
Mailing Address - Fax:
Practice Address - Street 1:2485 AUTUMNVALE DR, STE D
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95131
Practice Address - Country:US
Practice Address - Phone:408-909-0325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-30
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty