Healthcare Provider Details

I. General information

NPI: 1841551173
Provider Name (Legal Business Name): AKEMI ASAO L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2012
Last Update Date: 06/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2490 HOSPITAL DR SUITE 103-1
MOUNTAIN VIEW CA
94040-4122
US

IV. Provider business mailing address

10540 CHACE DR
CUPERTINO CA
95014-1061
US

V. Phone/Fax

Practice location:
  • Phone: 408-204-8051
  • Fax: 650-962-4641
Mailing address:
  • Phone: 408-204-8051
  • Fax: 650-962-4641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC14701
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: