Provider Demographics
NPI:1801364823
Name:ACUPUNCTURE & HEALING INC
Entity Type:Organization
Organization Name:ACUPUNCTURE & HEALING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CHANGE
Authorized Official - Middle Name:
Authorized Official - Last Name:PENG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:408-628-8317
Mailing Address - Street 1:4155 MOORPARK AVE STE #13
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95117
Mailing Address - Country:US
Mailing Address - Phone:408-628-8317
Mailing Address - Fax:
Practice Address - Street 1:4155 MOORPARK AVE STE #13
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95117
Practice Address - Country:US
Practice Address - Phone:408-628-8317
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-07
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty