Provider Demographics
NPI:1437329372
Name:AN, SANG HO (AC)
Entity Type:Individual
Prefix:
First Name:SANG HO
Middle Name:
Last Name:AN
Suffix:
Gender:M
Credentials:AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 S WOLFE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086-8806
Mailing Address - Country:US
Mailing Address - Phone:408-830-9195
Mailing Address - Fax:408-830-0080
Practice Address - Street 1:1021 S WOLFE RD STE 100
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086-8806
Practice Address - Country:US
Practice Address - Phone:408-830-9195
Practice Address - Fax:408-830-0080
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12242171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist