=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184374167
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALLCARE ACUPUNCTURE AND HERB CLINIC CORP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/24/2022
-----------------------------------------------------
Last Update Date | 03/24/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4986 CHERRY AVE
-----------------------------------------------------
City | SAN JOSE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95118-2748
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-593-6847
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2122 MONTEREY HWY APT 312
-----------------------------------------------------
City | SAN JOSE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95112-6153
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 669-224-5528
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ACUPUNCTURIST/CEO
-----------------------------------------------------
Name | RUILI ZHANG
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 408-593-6847
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------