Provider Demographics
NPI:1518091990
Name:MAGICAL HEALTH CENTER
Entity Type:Organization
Organization Name:MAGICAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:L.AC.
Authorized Official - Prefix:
Authorized Official - First Name:SHIMING
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-788-2299
Mailing Address - Street 1:3507 ALMA ST
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-3539
Mailing Address - Country:US
Mailing Address - Phone:415-788-2299
Mailing Address - Fax:
Practice Address - Street 1:3507 ALMA ST
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-3539
Practice Address - Country:US
Practice Address - Phone:415-788-2299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6171171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty