Provider Demographics
NPI:1811315989
Name:FAMILY WELLNESS ACUPUNCTURE INC
Entity type:Organization
Organization Name:FAMILY WELLNESS ACUPUNCTURE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:RYOKO
Authorized Official - Middle Name:
Authorized Official - Last Name:TAKAYAMA
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:949-836-2857
Mailing Address - Street 1:4950 BARRANCA PKWY
Mailing Address - Street 2:SUITE 301
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4671
Mailing Address - Country:US
Mailing Address - Phone:949-836-2857
Mailing Address - Fax:949-861-3270
Practice Address - Street 1:4950 BARRANCA PKWY
Practice Address - Street 2:SUITE 301
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4671
Practice Address - Country:US
Practice Address - Phone:949-836-2857
Practice Address - Fax:949-861-3270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-04
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty