Provider Demographics
NPI:1740523810
Name:WISE ACUPUNCTURE INC.
Entity type:Organization
Organization Name:WISE ACUPUNCTURE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TOYOSHIMA
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:619-339-8407
Mailing Address - Street 1:235 E BROADWAY
Mailing Address - Street 2:SUITE 524
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-3162
Mailing Address - Country:US
Mailing Address - Phone:619-339-8407
Mailing Address - Fax:
Practice Address - Street 1:235 E BROADWAY
Practice Address - Street 2:SUITE 524
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-3162
Practice Address - Country:US
Practice Address - Phone:619-339-8407
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-27
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14827171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty