Provider Demographics
NPI:1952959181
Name:MICROCOSMOS ACUPUNCTURE, INC.
Entity Type:Organization
Organization Name:MICROCOSMOS ACUPUNCTURE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RUNSHENG
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-678-9305
Mailing Address - Street 1:1601 DOVE ST STE 240
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2411
Mailing Address - Country:US
Mailing Address - Phone:949-932-0998
Mailing Address - Fax:949-932-0998
Practice Address - Street 1:1601 DOVE ST STE 240
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2411
Practice Address - Country:US
Practice Address - Phone:949-932-0998
Practice Address - Fax:949-932-0998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-30
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty