Provider Demographics
NPI:1881057503
Name:ONE SPRING ACUPUNCTURE LLC
Entity type:Organization
Organization Name:ONE SPRING ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:L.AC.
Authorized Official - Prefix:MS
Authorized Official - First Name:MINNA
Authorized Official - Middle Name:HAESEANG
Authorized Official - Last Name:RO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-420-0861
Mailing Address - Street 1:95 RODONOVAN DR
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-6657
Mailing Address - Country:US
Mailing Address - Phone:408-420-0861
Mailing Address - Fax:
Practice Address - Street 1:1925 WINCHESTER BLVD STE 103
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-1000
Practice Address - Country:US
Practice Address - Phone:408-420-0861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-31
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16233171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty