Provider Demographics
NPI:1730915091
Name:RENEW ACUPUNCTURE & WELLNESS INC
Entity type:Organization
Organization Name:RENEW ACUPUNCTURE & WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HUONG
Authorized Official - Middle Name:
Authorized Official - Last Name:TA
Authorized Official - Suffix:
Authorized Official - Credentials:DACM, LAC
Authorized Official - Phone:714-600-7612
Mailing Address - Street 1:10900 WESTMINSTER AVE STE 8
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-4918
Mailing Address - Country:US
Mailing Address - Phone:714-600-7612
Mailing Address - Fax:
Practice Address - Street 1:10900 WESTMINSTER AVE STE 8
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-4918
Practice Address - Country:US
Practice Address - Phone:714-600-7612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty