Provider Demographics
NPI:1457573529
Name:AMERICAN COLLEGE OF TRADITIONAL CHINESE MEDICINE
Entity Type:Organization
Organization Name:AMERICAN COLLEGE OF TRADITIONAL CHINESE MEDICINE
Other - Org Name:ACTCM
Other - Org Type:Other Name
Authorized Official - Title/Position:INSURANCE BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:PAOLINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MLADENOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-282-9603
Mailing Address - Street 1:455 ARKANSAS STREET
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107
Mailing Address - Country:US
Mailing Address - Phone:415-282-9603
Mailing Address - Fax:415-282-9037
Practice Address - Street 1:455 ARKANSAS STREET
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107
Practice Address - Country:US
Practice Address - Phone:415-282-9603
Practice Address - Fax:415-282-9037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty