Provider Demographics
NPI:1558591412
Name:AMERICAN CONSOTHERAPY CENTER
Entity Type:Organization
Organization Name:AMERICAN CONSOTHERAPY CENTER
Other - Org Name:UNION ACUPUNCTURE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:ZHONGXUE
Authorized Official - Last Name:MAH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LAC, MD( CHINA)
Authorized Official - Phone:650-350-1863
Mailing Address - Street 1:2304 S. EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403
Mailing Address - Country:US
Mailing Address - Phone:650-350-1863
Mailing Address - Fax:650-286-1965
Practice Address - Street 1:2304 S EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-2214
Practice Address - Country:US
Practice Address - Phone:650-350-1863
Practice Address - Fax:650-286-1965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-24
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5805171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty