MEDICARE: PAO HSUAN HUANG L.AC.

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	AC11204	CA

General Provider Information

NPI Number	:	1104003128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAO HSUAN HUANG L.AC.

Provider Business Mailing Address
First Line	:	120 E REMINGTON DR
Second Line	:	APT 614
City	:	SUNNYVALE
State	:	CA
Zip	:	94087-2654
Country	:	US
Telephone Number	:	408-230-2282
Fax Number	:	408-986-8597

Provider Business Practice Location Address
First Line	:	2338 CALLE DEL MUNDO
Second Line	:	SUITE A
City	:	SANTA CLARA
State	:	CA
Zip	:	95054-1045
Country	:	US
Telephone Number	:	408-986-8598
Fax Number	:	408-986-8597

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

Provider Enumeration Date	:	01/22/2008
Last Update Date	:	01/22/2008

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