Healthcare Provider Details

I. General information

NPI: 1811058423
Provider Name (Legal Business Name): WEN ZHOU ZHONG LICENSED ACUPUNCTURI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3608 TARAVAL ST
SAN FRANCISCO CA
94116
US

IV. Provider business mailing address

2130 40TH AVE
SAN FRANCISCO CA
94116
US

V. Phone/Fax

Practice location:
  • Phone: 415-566-2836
  • Fax: 415-566-2836
Mailing address:
  • Phone: 415-566-6098
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC10808
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: