Provider Demographics
NPI:1497046320
Name:SPLENDOR MANAGEMENT CORP
Entity Type:Organization
Organization Name:SPLENDOR MANAGEMENT CORP
Other - Org Name:SPLENDOR MEDICAL SPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHEN CHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:9258-339-4802
Mailing Address - Street 1:9260 ALCOSTA BLVD
Mailing Address - Street 2:BUILDING C-17
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-4134
Mailing Address - Country:US
Mailing Address - Phone:925-833-9482
Mailing Address - Fax:
Practice Address - Street 1:9260 ALCOSTA BLVD
Practice Address - Street 2:BUILDING C-17
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-4134
Practice Address - Country:US
Practice Address - Phone:925-833-9482
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-26
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 4689261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center