1902213754 NPI number — NEW START ACUPUNCTURE AND HERBS INC

Table of content: WELKY ALEXANDRA GALVIS FNP (NPI 1275187676)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902213754 NPI number — NEW START ACUPUNCTURE AND HERBS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW START ACUPUNCTURE AND 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:
1902213754
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/17/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14785 JEFFREY ROAD
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
IRVINE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92618
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-505-3433
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14785 JEFFREY ROAD
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
IRVINE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92618
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-505-3433
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/14/2014

Additional Information

Authorized Official

Authorized Official Last Name:
TIAN
Authorized Official First Name:
MEI
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
949-981-1140

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  AC 14170 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: AC 14170 . This is a "17" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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