Provider Demographics
NPI:1720562655
Name:MERIDIAN ACUPUNCTURE, INC.
Entity Type:Organization
Organization Name:MERIDIAN ACUPUNCTURE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LI-REN
Authorized Official - Middle Name:DELVAUX
Authorized Official - Last Name:WEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-380-9996
Mailing Address - Street 1:849 WINTERGREEN WAY
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-4109
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1220 UNIVERSITY DR STE 204
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-4265
Practice Address - Country:US
Practice Address - Phone:650-380-9996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty