=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124409008
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JNZ MEDICAL GROUP, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/16/2015
-----------------------------------------------------
Last Update Date | 11/29/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1828 EL CAMINO REAL STE. 804
-----------------------------------------------------
City | BURLINGAME
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94010-3103
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 650-580-8697
-----------------------------------------------------
Fax | 877-672-8403
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 709 WOODSIDE WAY APT A
-----------------------------------------------------
City | SAN MATEO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94401-1686
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 650-580-8697
-----------------------------------------------------
Fax | 877-672-8403
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. VINCENT ZHOU
-----------------------------------------------------
Credential | L.AC.
-----------------------------------------------------
Telephone | 650-580-8697
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | AC13784
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------