Provider Demographics
NPI:1891066304
Name:CALADRIUS HEALING CLINIC
Entity Type:Organization
Organization Name:CALADRIUS HEALING CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WALLACE
Authorized Official - Middle Name:
Authorized Official - Last Name:YUEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-301-3018
Mailing Address - Street 1:341 WESTLAKE CTR
Mailing Address - Street 2:SUITE 340
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-1441
Mailing Address - Country:US
Mailing Address - Phone:650-301-3018
Mailing Address - Fax:650-301-3018
Practice Address - Street 1:341 WESTLAKE CTR
Practice Address - Street 2:SUITE 340
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-1441
Practice Address - Country:US
Practice Address - Phone:650-301-3018
Practice Address - Fax:650-301-3018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-16
Last Update Date:2012-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3110248171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty