Provider Demographics
NPI:1598027948
Name:JASENG ACUPUNCTURE CLINIC
Entity Type:Organization
Organization Name:JASENG ACUPUNCTURE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DONG
Authorized Official - Middle Name:HA
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:408-645-8232
Mailing Address - Street 1:100 SARATOGA AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-7337
Mailing Address - Country:US
Mailing Address - Phone:408-645-8232
Mailing Address - Fax:
Practice Address - Street 1:100 SARATOGA AVE STE 110
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-7337
Practice Address - Country:US
Practice Address - Phone:408-645-8232
Practice Address - Fax:408-645-2415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC14070261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center