Provider Demographics
NPI:1740421742
Name:AD ACUPUNCTURE AND HERBS
Entity Type:Organization
Organization Name:AD ACUPUNCTURE AND HERBS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING AUTHORITY
Authorized Official - Prefix:MR
Authorized Official - First Name:DAMON
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:FRACH
Authorized Official - Suffix:
Authorized Official - Credentials:OFFICE MANAGER
Authorized Official - Phone:408-984-2455
Mailing Address - Street 1:1280 S ABEL ST
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-6266
Mailing Address - Country:US
Mailing Address - Phone:408-984-2455
Mailing Address - Fax:
Practice Address - Street 1:1280 S ABEL ST
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-6266
Practice Address - Country:US
Practice Address - Phone:408-984-2455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-20
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Multi-Specialty