Healthcare Provider Details

I. General information

NPI: 1750199139
Provider Name (Legal Business Name): TAI YI ORIENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2024
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 GEARY BLVD
SAN FRANCISCO CA
94118-3208
US

IV. Provider business mailing address

3701 GEARY BLVD STE 101
SAN FRANCISCO CA
94118-3208
US

V. Phone/Fax

Practice location:
  • Phone: 415-315-9100
  • 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: CHIN SHIN YANG
Title or Position: CEO
Credential:
Phone: 415-315-9100