Healthcare Provider Details

I. General information

NPI: 1265816235
Provider Name (Legal Business Name): BERKELEY HEALTH ACUPUNCTURE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2015
Last Update Date: 07/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2140 SHATTUCK AVE STE 510
BERKELEY CA
94704-1210
US

IV. Provider business mailing address

2140 SHATTUCK AVE STE 510
BERKELEY CA
94704-1210
US

V. Phone/Fax

Practice location:
  • Phone: 415-988-1619
  • Fax:
Mailing address:
  • Phone: 415-988-1619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC15390
License Number StateCA

VIII. Authorized Official

Name: ZHEN WANG
Title or Position: CEO
Credential:
Phone: 415-988-1619