Provider Demographics
NPI:1841834066
Name:DONGBANG ACUPUNCTURE CORPORATION
Entity type:Organization
Organization Name:DONGBANG ACUPUNCTURE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PREDIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:YAN FANG
Authorized Official - Middle Name:
Authorized Official - Last Name:HE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:510-367-8519
Mailing Address - Street 1:3231 TELEGRAPH AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3015
Mailing Address - Country:US
Mailing Address - Phone:510-367-8519
Mailing Address - Fax:
Practice Address - Street 1:3231 TELEGRAPH AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3015
Practice Address - Country:US
Practice Address - Phone:510-367-8519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty