MEDICARE: LINA ZHEN JIU LLC

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

General Provider Information

NPI Number	:	1407620826
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINA ZHEN JIU LLC

Provider Business Mailing Address
First Line	:	3873 QUANTUM DR UNIT 401
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94538-6860
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1717 N MILPITAS BLVD STE 1C
Second Line	:
City	:	MILPITAS
State	:	CA
Zip	:	95035-2727
Country	:	US
Telephone Number	:	669-263-6959
Fax Number	:

Authorized Official
Title or Position	:	MANAGER/CEO
Name	:	ANDRIY KUDRYAVTSEV
Credential	:
Telephone Number	:	305-731-4586

Provider Enumeration Date	:	11/07/2023
Last Update Date	:	03/20/2026

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Directions to “LINA ZHEN JIU LLC ” Practice Location

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