Provider Demographics
NPI:1952666224
Name:FOUR SEASONS OF WELLNESS ACUPUNCTURE INC.
Entity Type:Organization
Organization Name:FOUR SEASONS OF WELLNESS ACUPUNCTURE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MEI
Authorized Official - Middle Name:
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:530-753-3096
Mailing Address - Street 1:200 B ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-4575
Mailing Address - Country:US
Mailing Address - Phone:530-753-3096
Mailing Address - Fax:
Practice Address - Street 1:200 B ST
Practice Address - Street 2:SUITE B
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-4575
Practice Address - Country:US
Practice Address - Phone:530-753-3096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12310261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center