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General NPI Number Information
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NPI Number | 1285704346
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Entity Type | Organization
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Legal Business Name | ACUPUNCTURE & HERB CLINIC, INC.
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 970 CAMERADO DR STE 202
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City | CAMERON PARK
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State | CA
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Zip | 95682-7636
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Country | US
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Telephone | 530-677-0404
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Fax | 530-677-2504
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Provider Business Mailing Address
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Address Line | 970 CAMERADO DR STE 202
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City | CAMERON PARK
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State | CA
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Zip | 95682-7636
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Country | US
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Telephone | 530-677-0404
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Fax | 530-677-2504
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Authorized Official
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Title or Position | CFO
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Name | DAN ORTEGO
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Credential |
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Telephone | 530-677-0404
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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 | AC 7212
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License Number State | CA
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