Provider Demographics
NPI:1528361391
Name:SILICON VALLEY ACUPUNCTURE AND CHINESE MEDICINE
Entity Type:Organization
Organization Name:SILICON VALLEY ACUPUNCTURE AND CHINESE MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:YIQUN
Authorized Official - Middle Name:
Authorized Official - Last Name:SUN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:408-689-3846
Mailing Address - Street 1:3777 STEVENS CREEK BLVD
Mailing Address - Street 2:SUITE 300A
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-7364
Mailing Address - Country:US
Mailing Address - Phone:408-689-3846
Mailing Address - Fax:408-689-3846
Practice Address - Street 1:3777 STEVENS CREEK BLVD
Practice Address - Street 2:SUITE 300A
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-7364
Practice Address - Country:US
Practice Address - Phone:408-689-3846
Practice Address - Fax:408-689-3846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-16
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11342171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty