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General NPI Number Information
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NPI Number | 1073026183
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Entity Type | Organization
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Legal Business Name | DAO WELLNESS & ACUPUNCTURE CENTER, A PROF. ORG.
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Dates
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Enumeration Date | 11/10/2017
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Last Update Date | 11/10/2017
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Provider Practice Location Address
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Address Line | 6055 MERIDIAN AVE STE 30
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City | SAN JOSE
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State | CA
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Zip | 95120-2700
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Country | US
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Telephone | 408-766-1811
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Fax | 408-550-7112
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Provider Business Mailing Address
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Address Line | 6055 MERIDIAN AVE STE 30
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City | SAN JOSE
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State | CA
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Zip | 95120-2700
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Country | US
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Telephone | 408-766-1811
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Fax | 408-550-7112
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Authorized Official
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Title or Position | CEO / CHIEF ACUPUNCTURIST
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Name | MR. BRYAN J REISINGER
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Credential | L.AC., CMT, MTCM
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Telephone | 408-766-1811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 54384
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | A16628
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License Number State | CA
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