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General NPI Number Information
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NPI Number | 1104642479
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Entity Type | Organization
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Legal Business Name | GRANDPATH MEDICAL GROUP
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 3701 GEARY BLVD STE 101
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-3208
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Country | US
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Telephone | 510-480-6312
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Fax |
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Provider Business Mailing Address
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Address Line | 3701 GEARY BLVD STE 101
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-3208
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CHIN SHIN YANG
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Credential |
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Telephone | 415-994-4011
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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 |
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License Number State |
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