Provider Demographics
NPI:1790269058
Name:XLY ACUPUNCTURE CLINIC
Entity Type:Organization
Organization Name:XLY ACUPUNCTURE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:DR
Authorized Official - First Name:XIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-848-9387
Mailing Address - Street 1:1613 S MAIN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-6295
Mailing Address - Country:US
Mailing Address - Phone:203-848-9387
Mailing Address - Fax:
Practice Address - Street 1:110 DIXON RD
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-2500
Practice Address - Country:US
Practice Address - Phone:408-263-3238
Practice Address - Fax:408-247-3203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-21
Last Update Date:2023-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty