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General NPI Number Information
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NPI Number | 1104290535
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Entity Type | Organization
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Legal Business Name | TIEN ACUPUNCTURE INC
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Dates
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Enumeration Date | 11/23/2015
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Last Update Date | 11/23/2015
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Provider Practice Location Address
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Address Line | 2311 S EL CAMINO REAL
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City | SAN MATEO
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State | CA
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Zip | 94403-2213
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Country | US
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Telephone | 650-921-8681
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Fax | 650-332-2351
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Provider Business Mailing Address
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Address Line | 2311 S EL CAMINO REAL
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City | SAN MATEO
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State | CA
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Zip | 94403-2213
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Country | US
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Telephone | 650-921-8681
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Fax | 650-332-2351
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Authorized Official
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Title or Position | OWNER
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Name | WEI-I TIEN
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Credential | L.AC., DAOM
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Telephone | 650-921-8681
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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 | AC12381
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License Number State | CA
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