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General NPI Number Information
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NPI Number | 1235638040
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Entity Type | Organization
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Legal Business Name | GOLDEN SUMMIT ACUPUNCTURE
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Dates
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Enumeration Date | 02/07/2018
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Last Update Date | 02/07/2018
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Provider Practice Location Address
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Address Line | 2929 SUMMIT ST STE 102
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City | OAKLAND
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State | CA
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Zip | 94609-3423
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Country | US
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Telephone | 510-893-2929
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Fax |
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Provider Business Mailing Address
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Address Line | 2929 SUMMIT ST STE 102
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City | OAKLAND
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State | CA
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Zip | 94609-3423
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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 | ACUPUCTURIST/OWNER
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Name | LAURA HANKS
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Credential | L.AC., MSTCM
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Telephone | 206-604-2888
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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 | 17615
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License Number State | CA
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