1811281603 NPI number — WELL FAMILY ACUPUNCTURE & HERBS, INC.

Table of content: DR. BRENDA RENEE PALMER DDS (NPI 1295828317)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811281603 NPI number — WELL FAMILY ACUPUNCTURE & HERBS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WELL FAMILY ACUPUNCTURE & HERBS, 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:
1811281603
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/15/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3811 SCHAEFER AVE
Provider Second Line Business Mailing Address:
UNIT J
Provider Business Mailing Address City Name:
CHINO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91710-5400
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
909-591-0888
Provider Business Mailing Address Fax Number:
909-591-0889

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3811 SCHAEFER AVE
Provider Second Line Business Practice Location Address:
UNIT J
Provider Business Practice Location Address City Name:
CHINO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91710-5400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-591-0888
Provider Business Practice Location Address Fax Number:
909-591-0889
Provider Enumeration Date:
06/09/2011

Additional Information

Authorized Official

Authorized Official Last Name:
CHANG
Authorized Official First Name:
CHIA NING
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
626-898-2665

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  AC12548 , 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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