Provider Demographics
NPI:1518377399
Name:EMAC MEDICAL ANTI-AGING CENTER
Entity Type:Organization
Organization Name:EMAC MEDICAL ANTI-AGING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:Z
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-861-7903
Mailing Address - Street 1:441 DEGUIGNE DR. SUITE 101
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085
Mailing Address - Country:US
Mailing Address - Phone:408-523-1228
Mailing Address - Fax:408-523-1230
Practice Address - Street 1:441 DEGUIGNE DR. SUITE 101,
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085
Practice Address - Country:US
Practice Address - Phone:408-523-1228
Practice Address - Fax:408-523-1230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-02
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8874171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty