Healthcare Provider Details

I. General information

NPI: 1417022302
Provider Name (Legal Business Name): HIDEKO PELZER L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/23/2006
Last Update Date: 04/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1652 TUCSON CIR
SUISUN CITY CA
94585-6331
US

IV. Provider business mailing address

1652 TUCSON CIR
SUISUN CITY CA
94585-6331
US

V. Phone/Fax

Practice location:
  • Phone: 707-426-0615
  • Fax: 707-426-0615
Mailing address:
  • Phone: 707-426-0615
  • Fax: 707-426-0615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC6528
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: