Healthcare Provider Details

I. General information

NPI: 1861029431
Provider Name (Legal Business Name): RENEE YIN SHEN MIU DO, DAOM, LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 07/22/2023
Certification Date: 07/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4610 X ST STE 4202
SACRAMENTO CA
95817-2200
US

IV. Provider business mailing address

2701 DEL PASO RD STE 130-196
SACRAMENTO CA
95835-2305
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-7797
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP3934
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number20A21185
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC15253
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: