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General NPI Number Information
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NPI Number | 1184156184
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Entity Type | Organization
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Legal Business Name | GREENLEAF ACUPUNCTURE AND HERBS
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Dates
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Enumeration Date | 03/29/2017
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Last Update Date | 03/29/2017
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Provider Practice Location Address
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Address Line | 964 HURLSTONE LN
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City | SAN JOSE
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State | CA
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Zip | 95120-2116
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Country | US
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Telephone | 408-310-3451
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Fax |
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Provider Business Mailing Address
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Address Line | 964 HURLSTONE LN
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City | SAN JOSE
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State | CA
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Zip | 95120-2116
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Country | US
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Telephone | 408-310-3451
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JING LIU
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Credential |
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Telephone | 408-310-3451
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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 | AC16188
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License Number State | CA
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