Healthcare Provider Details

I. General information

NPI: 1780843896
Provider Name (Legal Business Name): ZHENYU QIU L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2008
Last Update Date: 06/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

368 S CALIFORNIA AVE
PALO ALTO CA
94306-1603
US

IV. Provider business mailing address

552 MARYLINN DR
MILPITAS CA
95035-4131
US

V. Phone/Fax

Practice location:
  • Phone: 650-328-9400
  • Fax:
Mailing address:
  • Phone: 408-946-8929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC8123
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: