Provider Demographics
NPI:1639405574
Name:PLAO ALTO INTEGRATIVE MEDICINE CENTER, INC.
Entity Type:Organization
Organization Name:PLAO ALTO INTEGRATIVE MEDICINE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MEILI
Authorized Official - Middle Name:
Authorized Official - Last Name:XU
Authorized Official - Suffix:
Authorized Official - Credentials:DOCTOR
Authorized Official - Phone:650-561-3088
Mailing Address - Street 1:122 SHERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-1822
Mailing Address - Country:US
Mailing Address - Phone:650-561-3088
Mailing Address - Fax:650-561-3186
Practice Address - Street 1:122 SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1822
Practice Address - Country:US
Practice Address - Phone:650-561-3088
Practice Address - Fax:650-561-3186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-28
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty