Provider Demographics
NPI:1013239631
Name:SAN BRUNO ACUPRESSURE INC
Entity type:Organization
Organization Name:SAN BRUNO ACUPRESSURE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:DAMON
Authorized Official - Last Name:FRACH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:408-984-2455
Mailing Address - Street 1:1474 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-5301
Mailing Address - Country:US
Mailing Address - Phone:408-984-2455
Mailing Address - Fax:408-984-2456
Practice Address - Street 1:53 CRONIN DR
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-6719
Practice Address - Country:US
Practice Address - Phone:408-984-2455
Practice Address - Fax:408-984-2456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty