1730615915 NPI number — ENERGY BODY ACUPUNCTURE INC.

Table of content: DR. DARYL LYNN AMMONS D.C. (NPI 1932135605)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730615915 NPI number — ENERGY BODY ACUPUNCTURE INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ENERGY BODY ACUPUNCTURE INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1730615915
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/05/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
116 E BROADWAY
Provider Second Line Business Mailing Address:
SUITE 203
Provider Business Mailing Address City Name:
GLENDALE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91205-1000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-437-8583
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
116 E BROADWAY
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
GLENDALE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91205-1000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-437-8583
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/05/2017

Additional Information

Authorized Official

Authorized Official Last Name:
YANG
Authorized Official First Name:
KUANG- CHEN
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
818-437-8583

Provider Taxonomy Codes

  • Taxonomy code: 302R00000X , with the licence number:  AC9818 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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