Provider Demographics
NPI:1225696180
Name:ACC ACUPUNCTURE AND CLEANSING CENTER
Entity Type:Organization
Organization Name:ACC ACUPUNCTURE AND CLEANSING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KUN
Authorized Official - Middle Name:
Authorized Official - Last Name:XIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-687-8115
Mailing Address - Street 1:1614 S DE ANZA BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-4608
Mailing Address - Country:US
Mailing Address - Phone:408-687-8115
Mailing Address - Fax:
Practice Address - Street 1:1614 S DE ANZA BLVD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-4608
Practice Address - Country:US
Practice Address - Phone:408-930-1585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-04
Last Update Date:2020-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty