Provider Demographics
NPI:1699833657
Name:TU, JASON TC (LAC)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:TC
Last Name:TU
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 MISSION SPRINGS CIR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95131-3033
Mailing Address - Country:US
Mailing Address - Phone:408-452-8128
Mailing Address - Fax:
Practice Address - Street 1:10787 S BLANEY AVE
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-4500
Practice Address - Country:US
Practice Address - Phone:408-257-4146
Practice Address - Fax:408-257-2156
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC3499171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist