Provider Demographics
NPI:1104351444
Name:FLOURISHING QI HEALTHCARE INC
Entity type:Organization
Organization Name:FLOURISHING QI HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WEIMING
Authorized Official - Middle Name:
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-618-1415
Mailing Address - Street 1:503 1/2 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-4459
Mailing Address - Country:US
Mailing Address - Phone:408-618-1415
Mailing Address - Fax:628-232-2468
Practice Address - Street 1:1101 S WINCHESTER BLVD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-3901
Practice Address - Country:US
Practice Address - Phone:408-618-1415
Practice Address - Fax:628-232-2468
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLOURISHING QI HEALTHCARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-04-24
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC16380261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center