Healthcare Provider Details

I. General information

NPI: 1033780697
Provider Name (Legal Business Name): ACUPUNCTURE VALLEY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2021
Last Update Date: 01/25/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39210 STATE ST STE 212
FREMONT CA
94538-1456
US

IV. Provider business mailing address

39210 STATE ST STE 212
FREMONT CA
94538-1456
US

V. Phone/Fax

Practice location:
  • Phone: 510-809-7261
  • Fax:
Mailing address:
  • Phone: 510-809-7261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BEI LIU
Title or Position: ACUPUNCTURIST
Credential: LAC.
Phone: 510-809-7261