Healthcare Provider Details

I. General information

NPI: 1760123079
Provider Name (Legal Business Name): YIZHUO RUI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2022
Last Update Date: 08/11/2022
Certification Date: 08/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 S WINCHESTER BLVD STE 2
SAN JOSE CA
95128-2932
US

IV. Provider business mailing address

1085 TASMAN DR SPC 310
SUNNYVALE CA
94089-5409
US

V. Phone/Fax

Practice location:
  • Phone: 408-868-2866
  • Fax:
Mailing address:
  • Phone: 646-238-7279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC19325
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: