Provider Demographics
NPI:1427604313
Name:FLYNN TCM CENTER
Entity Type:Organization
Organization Name:FLYNN TCM CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:YI-SHOU
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-620-2111
Mailing Address - Street 1:20600 MARIANI AVE STE D
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-2044
Mailing Address - Country:US
Mailing Address - Phone:408-620-2111
Mailing Address - Fax:
Practice Address - Street 1:20600 MARIANI AVE STE D
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-2044
Practice Address - Country:US
Practice Address - Phone:408-620-2111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-15
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty