Healthcare Provider Details

I. General information

NPI: 1457299802
Provider Name (Legal Business Name): CHICKEN SOUP ACUPUNCTURE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 SUTTER ST STE 203
SAN FRANCISCO CA
94115-3029
US

IV. Provider business mailing address

2300 SUTTER ST STE 203
SAN FRANCISCO CA
94115-3029
US

V. Phone/Fax

Practice location:
  • Phone: 415-861-1101
  • Fax: 415-644-0614
Mailing address:
  • Phone: 415-861-1101
  • Fax: 415-644-0614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MATTHEW KAMMERER
Title or Position: OWNER
Credential: LAC.
Phone: 415-861-1101