Healthcare Provider Details

I. General information

NPI: 1023550803
Provider Name (Legal Business Name): CAHEALTHCENTER IN PLEASANTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2016
Last Update Date: 11/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1393 SANTA RITA RD STE D
PLEASANTON CA
94566-5667
US

IV. Provider business mailing address

1393 SANTA RITA RD STE D
PLEASANTON CA
94566-5667
US

V. Phone/Fax

Practice location:
  • Phone: 925-600-1388
  • Fax:
Mailing address:
  • Phone: 925-600-1388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number3954376
License Number StateCA

VIII. Authorized Official

Name: MISS AMANDA LIU
Title or Position: OWNER
Credential:
Phone: 408-571-8839