Healthcare Provider Details

I. General information

NPI: 1932951308
Provider Name (Legal Business Name): GRAND TCM HEALING ACUPUNCTURE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2024
Last Update Date: 04/01/2024
Certification Date: 04/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4238 FOLSOM ST
SAN FRANCISCO CA
94110-6122
US

IV. Provider business mailing address

4238 FOLSOM ST
SAN FRANCISCO CA
94110-6122
US

V. Phone/Fax

Practice location:
  • Phone: 415-505-6002
  • Fax: 415-875-9372
Mailing address:
  • Phone: 415-646-3503
  • Fax: 415-875-9372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0000X
TaxonomyPain Management Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: JUXIANG NING
Title or Position: CEO
Credential: MD
Phone: 408-420-6722