Provider Demographics
NPI:1023537388
Name:ATP ACUPUNCTURE & HEALTH CENTER CORP.
Entity Type:Organization
Organization Name:ATP ACUPUNCTURE & HEALTH CENTER CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:TAO
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:510-673-5741
Mailing Address - Street 1:10062 MILLER AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-4580
Mailing Address - Country:US
Mailing Address - Phone:408-809-1614
Mailing Address - Fax:408-475-0588
Practice Address - Street 1:10062 MILLER AVE STE 220
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014
Practice Address - Country:US
Practice Address - Phone:408-809-1614
Practice Address - Fax:408-475-0588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-18
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC16880171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty