Provider Demographics
NPI:1619385499
Name:ACUPUNCTURE & TCM HERBALOGY LLC
Entity Type:Organization
Organization Name:ACUPUNCTURE & TCM HERBALOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:MAI
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:DAOM, LAC
Authorized Official - Phone:808-791-8313
Mailing Address - Street 1:311 OHUA AVE APT 1003C
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-3694
Mailing Address - Country:US
Mailing Address - Phone:808-791-8313
Mailing Address - Fax:808-791-8313
Practice Address - Street 1:311 OHUA AVE APT 1003C
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-3694
Practice Address - Country:US
Practice Address - Phone:808-791-8313
Practice Address - Fax:808-791-8313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty