Provider Demographics
NPI:1619481371
Name:DAHARA WELLNESS ACUPUNCTURE, INC.
Entity Type:Organization
Organization Name:DAHARA WELLNESS ACUPUNCTURE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YOUNG CHUN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOU
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:408-982-3002
Mailing Address - Street 1:3216 EL CAMINO REAL STE 9
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-2871
Mailing Address - Country:US
Mailing Address - Phone:408-982-3002
Mailing Address - Fax:408-642-1768
Practice Address - Street 1:3216 EL CAMINO REAL STE 9
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-2871
Practice Address - Country:US
Practice Address - Phone:408-982-3002
Practice Address - Fax:408-642-1768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-16
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC15893171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty