Healthcare Provider Details

I. General information

NPI: 1104525476
Provider Name (Legal Business Name): SESAME ACUPUNCTURE CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2023
Last Update Date: 04/20/2023
Certification Date: 04/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 W MAUDE AVE STE 110
SUNNYVALE CA
94085-4367
US

IV. Provider business mailing address

333 W MAUDE AVE STE 110
SUNNYVALE CA
94085-4367
US

V. Phone/Fax

Practice location:
  • Phone: 669-252-0521
  • Fax:
Mailing address:
  • Phone: 669-252-0521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: JIAJIA ZHUANG
Title or Position: ACUPUNCTURIST
Credential:
Phone: 669-252-0521