Provider Demographics
NPI:1740743566
Name:LING ZHEN TANG LLC
Entity Type:Organization
Organization Name:LING ZHEN TANG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:XINGQUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-812-7395
Mailing Address - Street 1:5145 STEVENS CREEK BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-6667
Mailing Address - Country:US
Mailing Address - Phone:408-490-4859
Mailing Address - Fax:
Practice Address - Street 1:5145 STEVENS CREEK BLVD STE 110
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-6667
Practice Address - Country:US
Practice Address - Phone:408-490-4859
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty