Healthcare Provider Details

I. General information

NPI: 1962094375
Provider Name (Legal Business Name): SYDNEY MALAWER ACUPUNCTURE & HERBAL MEDICINE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2021
Last Update Date: 02/08/2021
Certification Date: 02/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1283 GILMAN ST
BERKELEY CA
94706-2351
US

IV. Provider business mailing address

112 BEHRENS ST
EL CERRITO CA
94530-3703
US

V. Phone/Fax

Practice location:
  • Phone: 510-214-2980
  • Fax:
Mailing address:
  • Phone: 914-584-4239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. SYDNEY MALAWER
Title or Position: PRESIDENT
Credential: L.AC.
Phone: 510-214-2980