Provider Demographics
NPI:1659097103
Name:SILVER FRUIT ACUPUNCTURE
Entity Type:Organization
Organization Name:SILVER FRUIT ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAURENZI
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:510-355-6874
Mailing Address - Street 1:2935 VAN NESS AVE APT 11
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-1028
Mailing Address - Country:US
Mailing Address - Phone:510-355-6874
Mailing Address - Fax:
Practice Address - Street 1:2137 LOMBARD ST FL 2
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-2773
Practice Address - Country:US
Practice Address - Phone:510-355-6874
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center