Provider Demographics
NPI:1174039911
Name:ACUPUNCTURE & CHINESE HERBAL MEDICINE
Entity Type:Organization
Organization Name:ACUPUNCTURE & CHINESE HERBAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHNSON
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIU
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:650-225-0808
Mailing Address - Street 1:1590 EL CAMINO REAL STE G
Mailing Address - Street 2:
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-5377
Mailing Address - Country:US
Mailing Address - Phone:650-225-0808
Mailing Address - Fax:650-225-0809
Practice Address - Street 1:1590 EL CAMINO REAL STE G
Practice Address - Street 2:
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-5377
Practice Address - Country:US
Practice Address - Phone:650-225-0808
Practice Address - Fax:650-225-0809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-15
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC9134171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty