Provider Demographics
NPI:1609118082
Name:ACUPUNCTURE HEALTHCARE CLINIC OF FREMONT, INC.
Entity Type:Organization
Organization Name:ACUPUNCTURE HEALTHCARE CLINIC OF FREMONT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:NA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHAO
Authorized Official - Suffix:
Authorized Official - Credentials:LAC , PHD
Authorized Official - Phone:650-799-3118
Mailing Address - Street 1:200 BROWN RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-7955
Mailing Address - Country:US
Mailing Address - Phone:650-799-3118
Mailing Address - Fax:
Practice Address - Street 1:200 BROWN RD
Practice Address - Street 2:SUITE 206
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-7955
Practice Address - Country:US
Practice Address - Phone:650-799-3118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-23
Last Update Date:2013-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC7275171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty