Provider Demographics
NPI:1194559088
Name:JAVA ACUPUNCTURE INTEGRATIVE MEDICINE, PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:JAVA ACUPUNCTURE INTEGRATIVE MEDICINE, PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINH
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DTCM, LAC
Authorized Official - Phone:310-926-6106
Mailing Address - Street 1:3782 KIRK RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-3818
Mailing Address - Country:US
Mailing Address - Phone:310-926-6106
Mailing Address - Fax:408-400-3306
Practice Address - Street 1:2100 FOREST AVE STE 101
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1422
Practice Address - Country:US
Practice Address - Phone:408-818-8004
Practice Address - Fax:408-400-3306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-02
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty