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General NPI Number Information
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NPI Number | 1508364621
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Entity Type | Organization
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Legal Business Name | EDITH NUNEZ ACUPUNCTURE
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Dates
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Enumeration Date | 01/23/2018
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Last Update Date | 01/23/2018
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Provider Practice Location Address
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Address Line | 638 STANYAN ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94117-1807
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Country | US
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Telephone | 415-598-7589
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Fax |
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Provider Business Mailing Address
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Address Line | 460 MARIETTA DR
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City | SAN FRANCISCO
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State | CA
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Zip | 94127-1820
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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 | ACUPUNCTURIST
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Name | EDITH NUNEZ BAZA
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Credential | L.AC.
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Telephone | 415-598-7589
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 16575
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 16575
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License Number State | CA
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