Provider Demographics
NPI:1629350533
Name:HAPPY VALLEY ACUPUNCTURE & HERBAL CENTER, INC.
Entity Type:Organization
Organization Name:HAPPY VALLEY ACUPUNCTURE & HERBAL CENTER, INC.
Other - Org Name:HAPPY VALLEY ACUPUNCTURE & HERBS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BOB
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:626-839-5697
Mailing Address - Street 1:17595 ALMAHUST RD.
Mailing Address - Street 2:SUITE # 230
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91748
Mailing Address - Country:US
Mailing Address - Phone:626-839-5697
Mailing Address - Fax:
Practice Address - Street 1:17595 ALMAHURST ST STE 230
Practice Address - Street 2:
Practice Address - City:CITY OF INDUSTRY
Practice Address - State:CA
Practice Address - Zip Code:91748-1799
Practice Address - Country:US
Practice Address - Phone:626-839-5697
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-16
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC14145171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty