Provider Demographics
NPI:1497141766
Name:EAST-WEST INTEGRATIVE MEDICINE AND ACUPUNCTURE CLINIC , A PROFESSIONAL
Entity Type:Organization
Organization Name:EAST-WEST INTEGRATIVE MEDICINE AND ACUPUNCTURE CLINIC , A PROFESSIONAL
Other - Org Name:EAST-WEST INTEGRATIVE MEDICINE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARNIE
Authorized Official - Middle Name:RACHELE
Authorized Official - Last Name:MCCURDY
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:415-585-1990
Mailing Address - Street 1:605 CHENERY ST STE B&C
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94131-3033
Mailing Address - Country:US
Mailing Address - Phone:415-585-1990
Mailing Address - Fax:
Practice Address - Street 1:605 CHENERY ST STE B&C
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94131-3033
Practice Address - Country:US
Practice Address - Phone:415-585-1990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-13
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8910171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty