Healthcare Provider Details

I. General information

NPI: 1427111699
Provider Name (Legal Business Name): 1-2-3 ACUPUNCTURE CLINIC, PROFESSIONAL CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 07/08/2022
Certification Date: 07/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4666 EL CAMINO REAL
LOS ALTOS CA
94022-1329
US

IV. Provider business mailing address

4666 EL CAMINO REAL
LOS ALTOS CA
94022-1329
US

V. Phone/Fax

Practice location:
  • Phone: 650-949-2339
  • Fax:
Mailing address:
  • Phone: 650-949-2339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. CAIQIN LIU
Title or Position: PRESIDENT
Credential: L.AC.
Phone: 650-949-2339