Provider Demographics
NPI:1104981844
Name:HERCULES ACUPUNCTURE, PROF. CORP.
Entity type:Organization
Organization Name:HERCULES ACUPUNCTURE, PROF. CORP.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AJ
Authorized Official - Middle Name:H
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:510-741-7300
Mailing Address - Street 1:500 ALFRED NOBEL DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:HERCULES
Mailing Address - State:CA
Mailing Address - Zip Code:94547-1838
Mailing Address - Country:US
Mailing Address - Phone:510-741-7300
Mailing Address - Fax:510-741-7360
Practice Address - Street 1:500 ALFRED NOBEL DR
Practice Address - Street 2:SUITE 220
Practice Address - City:HERCULES
Practice Address - State:CA
Practice Address - Zip Code:94547-1838
Practice Address - Country:US
Practice Address - Phone:510-741-7300
Practice Address - Fax:510-741-7360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC9156171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty