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General NPI Number Information
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NPI Number | 1003299157
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Entity Type | Individual
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Provider Name | KAMOLLUCK TRATENG L.AC.
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Gender | Female
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Dates
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Enumeration Date | 07/08/2015
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 500 E REMINGTON DR STE 28
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City | SUNNYVALE
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State | CA
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Zip | 94087-2612
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Country | US
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Telephone | 541-250-2012
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Fax | 408-413-1142
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Provider Business Mailing Address
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Address Line | 16999 MCGILL RD
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City | SARATOGA
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State | CA
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Zip | 95070-9602
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Country | US
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Telephone | 541-250-2012
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Fax | 408-413-1142
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC 16450
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License Number State | CA
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