MEDICARE: SAN BRUNO ACUPRESSURE

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	:	1699141333
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAN BRUNO ACUPRESSURE

Provider Business Mailing Address
First Line	:	53 CRONIN DR
Second Line	:
City	:	SANTA CLARA
State	:	CA
Zip	:	95051-6719
Country	:	US
Telephone Number	:	408-480-3006
Fax Number	:	408-984-2455

Provider Business Practice Location Address
First Line	:	1474 EL CAMINO REAL
Second Line	:
City	:	SAN BRUNO
State	:	CA
Zip	:	94066-5301
Country	:	US
Telephone Number	:	650-616-9098
Fax Number	:	650-616-9098

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	TIANLIN LI
Credential	:
Telephone Number	:	650-616-9098

Provider Enumeration Date	:	08/17/2015
Last Update Date	:	08/17/2015

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