MEDICARE: ACUPUNCTURE & MOXA, INC.

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	13459	CA

General Provider Information

NPI Number	:	1871895714
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACUPUNCTURE & MOXA, INC.

Provider Business Mailing Address
First Line	:	490 POST ST
Second Line	:	STE 1210
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94102-1303
Country	:	US
Telephone Number	:	415-834-9198
Fax Number	:	925-254-1119

Provider Business Practice Location Address
First Line	:	490 POST ST
Second Line	:	STE 1210
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94102-1303
Country	:	US
Telephone Number	:	415-834-9198
Fax Number	:	925-254-1119

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. JEON HEE JANG
Credential	:	LAC
Telephone Number	:	415-834-9198

Provider Enumeration Date	:	11/29/2010
Last Update Date	:	06/09/2015

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