Provider Demographics
NPI:1417590001
Name:MOAFI CEFALU ACUPUNCTURE, INC.
Entity Type:Organization
Organization Name:MOAFI CEFALU ACUPUNCTURE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:SETAREH
Authorized Official - Middle Name:
Authorized Official - Last Name:MOAFI
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:408-244-8565
Mailing Address - Street 1:1817 PRUNERIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-6528
Mailing Address - Country:US
Mailing Address - Phone:408-244-8565
Mailing Address - Fax:
Practice Address - Street 1:1817 PRUNERIDGE AVE
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-6528
Practice Address - Country:US
Practice Address - Phone:408-244-8565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-25
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1952545675OtherSETAREH MOAFI'S NPI
CA1609014059OtherSALVADOR CEFALU'S NPI