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General NPI Number Information
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NPI Number | 1508114935
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Entity Type | Organization
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Legal Business Name | ACUPUNCTURE AND HOLISTIC MEDICINE INC.
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Dates
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Enumeration Date | 08/15/2012
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Last Update Date | 08/15/2012
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Provider Practice Location Address
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Address Line | 1283 GILMAN ST
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City | BERKELEY
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State | CA
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Zip | 94706-2351
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Country | US
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Telephone | 510-731-7535
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Fax |
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Provider Business Mailing Address
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Address Line | 829 SHATTUCK AVE
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City | BERKELEY
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State | CA
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Zip | 94707-2019
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Country | US
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Telephone | 510-731-7535
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | NANCY GUILD
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Credential |
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Telephone | 714-944-8162
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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 | AC13767
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License Number State | CA
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