Healthcare Provider Details

I. General information

NPI: 1699587881
Provider Name (Legal Business Name): DAO ACUPUNCTURE AND HERB, PROFESSIONAL CORPOERATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2025
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12625 HIGH BLUFF DR STE 101
SAN DIEGO CA
92130-2053
US

IV. Provider business mailing address

PO BOX 721711
SAN DIEGO CA
92172-1711
US

V. Phone/Fax

Practice location:
  • Phone: 619-732-6896
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: STACY TU
Title or Position: PRESIDENT
Credential:
Phone: 619-732-6896