Organization
MIRACLE WANDS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LYNDY NGU (CEO)
(213) 271-5925
Entity
Organization
Contact information
Practice address
1143 STORY RD STE 250&260, SAN JOSE, CA 95122-2610
(408) 899-2254
Mailing address
1143 STORY RD STE 250&260, SAN JOSE, CA 95122-2610
(408) 899-2254
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
54418
CA
Other
Enumeration date
03/27/2017
Last updated
03/27/2017
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