NPIMap

Organization Active NPI

Fang Mao Medical Group

Doing business as Profound Youth Acupuncture

  • Acupuncturist
  • Corona, CA
National Provider Identifier
1477875862
Registry record updated Feb 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC11187 Issued in CA
Legal business name
FANG MAO MEDICAL GROUP
Doing business as
Profound Youth Acupuncture
Practice address
760 Washburn Ave
Suite # 23
Corona, CA 92882-3303
Phone
(951) 582-0999
Fax
(951) 582-0900
NPI assigned
Feb 25, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. CHI Fang Hsu, L.AC., O.M.D.NPI 1154573004
Title
Acupuncturist / President
Phone
(951) 582-0999

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193400000X SINGLE SPECIALTY GROUP 171100000X AC11187 CA Primary

Addresses

Primary practice location

760 Washburn Ave
Suite # 23
Corona, CA 92882-3303

Mailing address

760 Washburn Ave
Suite # 23
Corona, CA 92882-3303
Phone (951) 582-0999

Other names 1

  • Profound Youth Acupuncture Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1267056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267056000000",
    "number": "1477875862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 WASHBURN AVE",
            "address_2": "SUITE # 23",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928823303",
            "telephone_number": "951-582-0999",
            "fax_number": "951-582-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 WASHBURN AVE",
            "address_2": "SUITE # 23",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928823303",
            "telephone_number": "951-582-0999",
            "fax_number": "951-582-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FANG MAO MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-25",
        "last_updated": "2010-02-25",
        "status": "A",
        "authorized_official_last_name": "HSU",
        "authorized_official_first_name": "CHI FANG",
        "authorized_official_title_or_position": "ACUPUNCTURIST / PRESIDENT",
        "authorized_official_telephone_number": "951-582-0999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "L.AC., O.M.D."
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC11187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Profound Youth Acupuncture",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.