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General NPI Number Information
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NPI Number | 1659419265
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Entity Type | Organization
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Legal Business Name | BYRD ACUPUNCTURE, INC.
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Dates
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Enumeration Date | 02/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 20 S SANTA CRUZ AVE SUITE 307
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City | LOS GATOS
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State | CA
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Zip | 95030-6830
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Country | US
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Telephone | 408-399-6114
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Fax |
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Provider Business Mailing Address
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Address Line | 1905 JOSE AVE
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City | SANTA CRUZ
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State | CA
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Zip | 95062-1603
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Country | US
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Telephone | 831-479-8809
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DUANE BYRD
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Credential | L.AC.
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Telephone | 831-295-3541
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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 11328
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License Number State | CA
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