Provider Demographics
NPI:1053619726
Name:WATERFRONT ACUPUNCTURE
Entity type:Organization
Organization Name:WATERFRONT ACUPUNCTURE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:YUNG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:510-533-3222
Mailing Address - Street 1:1211 EMBARCADERO STE 200
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-5117
Mailing Address - Country:US
Mailing Address - Phone:510-533-3222
Mailing Address - Fax:510-533-3210
Practice Address - Street 1:1211 EMBARCADERO STE 200
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94606-5117
Practice Address - Country:US
Practice Address - Phone:510-533-3222
Practice Address - Fax:510-533-3210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-04
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty