Provider Demographics
NPI:1821122730
Name:HERBAL INN CALIFORNIA
Entity Type:Organization
Organization Name:HERBAL INN CALIFORNIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:TAI SHEN
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:01144208-349-0640
Mailing Address - Street 1:2200 EASTRIDGE LOOP
Mailing Address - Street 2:2101
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95122-1410
Mailing Address - Country:US
Mailing Address - Phone:408-528-8808
Mailing Address - Fax:408-528-8808
Practice Address - Street 1:2200 EASTRIDGE LOOP
Practice Address - Street 2:2101
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122-1410
Practice Address - Country:US
Practice Address - Phone:408-528-8808
Practice Address - Fax:408-528-8808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty