Provider Demographics
NPI:1033892104
Name:RED JADE ACUPUNCTURE CLINIC
Entity Type:Organization
Organization Name:RED JADE ACUPUNCTURE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RED JADE ACUPUNCTURE CLINIC
Authorized Official - Prefix:PROF
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:ZHENG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:628-224-5808
Mailing Address - Street 1:1921 S EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-1321
Mailing Address - Country:US
Mailing Address - Phone:628-224-5808
Mailing Address - Fax:
Practice Address - Street 1:1921 S EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-1321
Practice Address - Country:US
Practice Address - Phone:628-224-5808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-07
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty