Provider Demographics
NPI:1821396037
Name:ACUPUNCTURE AND CHINESE MEDICINE HEALING CLINIC
Entity Type:Organization
Organization Name:ACUPUNCTURE AND CHINESE MEDICINE HEALING CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:KAO
Authorized Official - Suffix:
Authorized Official - Credentials:DAOM, LAC
Authorized Official - Phone:415-586-5900
Mailing Address - Street 1:430 40TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-2691
Mailing Address - Country:US
Mailing Address - Phone:510-844-0095
Mailing Address - Fax:510-844-0095
Practice Address - Street 1:30 MONTEREY BLVD
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94131-3235
Practice Address - Country:US
Practice Address - Phone:415-586-5900
Practice Address - Fax:415-334-2538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-11
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8769171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty