Provider Demographics
NPI:1821271206
Name:JAPAN TOWN ACUPUNCTURE & ORIENTAL MEDICINE, INC.
Entity Type:Organization
Organization Name:JAPAN TOWN ACUPUNCTURE & ORIENTAL MEDICINE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:YUKO
Authorized Official - Middle Name:
Authorized Official - Last Name:GOWER
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:415-922-2100
Mailing Address - Street 1:1581 WEBSTER ST
Mailing Address - Street 2:SUITE 245
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3638
Mailing Address - Country:US
Mailing Address - Phone:415-922-2100
Mailing Address - Fax:
Practice Address - Street 1:1581 WEBSTER ST
Practice Address - Street 2:SUITE 245
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3638
Practice Address - Country:US
Practice Address - Phone:415-922-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-09
Last Update Date:2007-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8223171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty