Healthcare Provider Details
I. General information
NPI: 1033395231
Provider Name (Legal Business Name): AIMC BERKELEY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/17/2008
Last Update Date: 01/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2550 SHATTUCK AVE
BERKELEY CA
94704-2724
US
IV. Provider business mailing address
2550 SHATTUCK AVE
BERKELEY CA
94704-2724
US
V. Phone/Fax
- Phone: 510-666-8234
- Fax:
- Phone: 510-666-8234
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
BRUCE
ROBINSON
Title or Position: PRESIDENT
Credential: M.D.
Phone: 510-666-8234