Provider Demographics
NPI:1356891642
Name:MING ACUPUNCTURE AND HERB CENTER,P.C.
Entity type:Organization
Organization Name:MING ACUPUNCTURE AND HERB CENTER,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:YOURUI
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:650-320-9538
Mailing Address - Street 1:809 SAN ANTONIO RD
Mailing Address - Street 2:#10
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-4634
Mailing Address - Country:US
Mailing Address - Phone:650-320-9538
Mailing Address - Fax:
Practice Address - Street 1:809 SAN ANTONIO RD
Practice Address - Street 2:#10
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-4634
Practice Address - Country:US
Practice Address - Phone:650-320-9538
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 16696305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization