Healthcare Provider Details

I. General information

NPI: 1508937178
Provider Name (Legal Business Name): DR ERIC ZHAOS ACUPUNCTURE & HERBAL CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 08/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3737 EUBANK NE
ALBUQUERQUE NM
87111
US

IV. Provider business mailing address

3737 EUBANK NE PO BOX 92786
ALBUQUERQUE NM
87111
US

V. Phone/Fax

Practice location:
  • Phone: 505-889-5299
  • Fax: 505-881-5231
Mailing address:
  • Phone: 505-881-5299
  • Fax: 505-881-5231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number556 672
License Number StateNM

VIII. Authorized Official

Name: YU ERIC ZHAO
Title or Position: DOM PRESIDENT
Credential: DOM
Phone: 505-881-5299