Provider Demographics
NPI:1942606561
Name:REAL HEALTH ACUPUNCTURE & HERBS
Entity Type:Organization
Organization Name:REAL HEALTH ACUPUNCTURE & HERBS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:909-628-5880
Mailing Address - Street 1:5385 WALNUT AVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-2605
Mailing Address - Country:US
Mailing Address - Phone:909-628-5880
Mailing Address - Fax:909-628-5882
Practice Address - Street 1:5385 WALNUT AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-2605
Practice Address - Country:US
Practice Address - Phone:909-628-5880
Practice Address - Fax:909-628-5882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-10
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC16179171100000X
305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
No305R00000XManaged Care OrganizationsPreferred Provider OrganizationGroup - Single Specialty