MEDICARE: MR. WEI-I TIEN 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	AC 12381	CA

General Provider Information

NPI Number	:	1528232584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WEI-I TIEN L. AC.

Provider Business Mailing Address
First Line	:	2311 S EL CAMINO REAL
Second Line	:
City	:	SAN MATEO
State	:	CA
Zip	:	94403-2213
Country	:	US
Telephone Number	:	650-921-8681
Fax Number	:	650-588-7037

Provider Business Practice Location Address
First Line	:	2311 S EL CAMINO REAL
Second Line	:
City	:	SAN MATEO
State	:	CA
Zip	:	94403-2213
Country	:	US
Telephone Number	:	650-921-8681
Fax Number	:	650-588-7037

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

Provider Enumeration Date	:	04/21/2008
Last Update Date	:	06/02/2010

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