Healthcare Provider Details

I. General information

NPI: 1801368303
Provider Name (Legal Business Name): TRISINCERE CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2018
Last Update Date: 12/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

979 BROADWAY STE 202
MILLBRAE CA
94030-1993
US

IV. Provider business mailing address

979 BROADWAY STE 202
MILLBRAE CA
94030-1993
US

V. Phone/Fax

Practice location:
  • Phone: 415-661-7288
  • Fax:
Mailing address:
  • Phone: 415-661-7288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: QI REN LI
Title or Position: OFFICE MANAGER
Credential: L.AC
Phone: 415-661-7288