Provider Demographics
NPI:1609146752
Name:21ST CENTURY HERBS & HEALTH
Entity Type:Organization
Organization Name:21ST CENTURY HERBS & HEALTH
Other - Org Name:21ST CENTURY HERBS & ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR (OWNER)
Authorized Official - Prefix:DR
Authorized Official - First Name:JIANGHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:909-869-1999
Mailing Address - Street 1:20657 GOLDEN SPRING DRIVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91789
Mailing Address - Country:US
Mailing Address - Phone:909-869-1999
Mailing Address - Fax:909-266-2034
Practice Address - Street 1:20657 GOLDEN SPRING DRIVE
Practice Address - Street 2:SUITE 108
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91789
Practice Address - Country:US
Practice Address - Phone:909-869-1999
Practice Address - Fax:909-266-2034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC10885171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty