=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548824402
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CINDY'S ACUPUNCTURE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/25/2019
-----------------------------------------------------
Last Update Date | 04/25/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 21040 HOMESTEAD RD STE 102
-----------------------------------------------------
City | CUPERTINO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95014-0238
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 669-281-9403
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 21040 HOMESTEAD RD STE 102
-----------------------------------------------------
City | CUPERTINO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95014-0238
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 669-281-9403
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | XINJUN LI
-----------------------------------------------------
Credential | LAC
-----------------------------------------------------
Telephone | 669-281-9403
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------