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General NPI Number Information
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NPI Number | 1285381160
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Entity Type | Organization
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Legal Business Name | MORISHIGE ACUPUNCTURE, FUNCTIONAL MEDICINE & HERBAL PHARMACY
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Dates
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Enumeration Date | 03/09/2022
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Last Update Date | 03/09/2022
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Provider Practice Location Address
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Address Line | 1417 SANTA CRUZ DR
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City | SANTA FE
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State | NM
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Zip | 87505-3861
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Country | US
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Telephone | 505-690-3777
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Fax |
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Provider Business Mailing Address
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Address Line | 2641 HENRY AVE
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City | PINOLE
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State | CA
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Zip | 94564-1358
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Country | US
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Telephone | 505-690-3777
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | GINA MORISHIGE
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Credential | DOM, CFMP, RX, CPT
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Telephone | 505-690-3777
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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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