MEDICARE: MS. YONG CHUN SHA LC.A

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	12965	CA

General Provider Information

NPI Number	:	1033345905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. YONG CHUN SHA LC.A

Provider Business Mailing Address
First Line	:	PO BOX 2746
Second Line	:
City	:	CUPERTINO
State	:	CA
Zip	:	95015-2746
Country	:	US
Telephone Number	:	408-585-8770
Fax Number	:	408-773-8961

Provider Business Practice Location Address
First Line	:	1324 S MARY AVE
Second Line	:
City	:	SUNNYVALE
State	:	CA
Zip	:	94087-3130
Country	:	US
Telephone Number	:	408-585-8770
Fax Number	:	408-773-8961

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2009
Last Update Date	:	06/12/2012

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