Provider Demographics
NPI:1669179107
Name:BLISS ACUPUNCTURE WELLNESS LLC
Entity type:Organization
Organization Name:BLISS ACUPUNCTURE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:XIAOBO
Authorized Official - Middle Name:
Authorized Official - Last Name:PENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-714-8569
Mailing Address - Street 1:6115 EXECUCTIVE BLVD
Mailing Address - Street 2:SUITE 1-A
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852
Mailing Address - Country:US
Mailing Address - Phone:240-714-8569
Mailing Address - Fax:
Practice Address - Street 1:6115 EXECUCTIVE BLVD
Practice Address - Street 2:SUITE 1-A
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852
Practice Address - Country:US
Practice Address - Phone:240-714-8569
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDU02776OtherACUPUNCTURIST