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General NPI Number Information
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NPI Number | 1558591412
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Entity Type | Organization
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Legal Business Name | AMERICAN CONSOTHERAPY CENTER
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Dates
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Enumeration Date | 07/24/2009
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Last Update Date | 07/24/2009
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Provider Practice Location Address
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Address Line | 2304 S EL CAMINO REAL
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City | SAN MATEO
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State | CA
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Zip | 94403-2214
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Country | US
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Telephone | 650-350-1863
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Fax | 650-286-1965
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Provider Business Mailing Address
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Address Line | 2304 S. EL CAMINO REAL
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City | SAN MATEO
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State | CA
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Zip | 94403
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Country | US
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Telephone | 650-350-1863
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Fax | 650-286-1965
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFFREY ZHONGXUE MAH
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Credential | PHD, LAC, MD( CHINA)
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Telephone | 650-350-1863
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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 | 5805
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License Number State | CA
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