Healthcare Provider Details

I. General information

NPI: 1023250297
Provider Name (Legal Business Name): MS. JIALI ZHU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2009
Last Update Date: 04/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10201 IMPERIAL AVE SUITE 103
CUPERTINO CA
95014-5946
US

IV. Provider business mailing address

1236 CORTEZ DR APT 12
SUNNYVALE CA
94086-5672
US

V. Phone/Fax

Practice location:
  • Phone: 408-973-8179
  • Fax: 650-965-2080
Mailing address:
  • Phone: 408-973-8179
  • Fax: 650-965-2080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number13043
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: