Provider Demographics
NPI:1598844938
Name:HARMONY CLINIC ACUPUNCTURE & HERBS, INC
Entity Type:Organization
Organization Name:HARMONY CLINIC ACUPUNCTURE & HERBS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:XING-JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-784-0089
Mailing Address - Street 1:6800 INDIANA AVE
Mailing Address - Street 2:SUITE#100
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-4269
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:951-784-0289
Practice Address - Street 1:6800 INDIANA AVE
Practice Address - Street 2:SUITE#100
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-4269
Practice Address - Country:US
Practice Address - Phone:951-784-0089
Practice Address - Fax:951-784-0289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-05
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 3971171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC0039710OtherMEDICAL
CAZZZ135852OtherBLUE SHIELD OF CALIFORNIA