Provider Demographics
NPI:1437466901
Name:RADIANT CHIROPRACTIC AND ACUPUNCTURE
Entity Type:Organization
Organization Name:RADIANT CHIROPRACTIC AND ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:M
Authorized Official - Last Name:WOO
Authorized Official - Suffix:
Authorized Official - Credentials:DC, LAC
Authorized Official - Phone:408-749-1558
Mailing Address - Street 1:525 W. REMINGTON DR.
Mailing Address - Street 2:STE 120
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087
Mailing Address - Country:US
Mailing Address - Phone:408-749-1558
Mailing Address - Fax:408-749-0928
Practice Address - Street 1:525 W. REMINGTON DR.
Practice Address - Street 2:STE 120
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087
Practice Address - Country:US
Practice Address - Phone:408-749-1558
Practice Address - Fax:408-749-0928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-07
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 29274111N00000X
CAAC 12302171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty