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General NPI Number Information
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NPI Number | 1679892152
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Entity Type | Organization
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Legal Business Name | CUPERTINO-CENTER ACUPUNCTURE
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Dates
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Enumeration Date | 05/24/2010
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Last Update Date | 05/24/2010
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Provider Practice Location Address
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Address Line | 10301 S DE ANZA BLVD SUITE 5
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City | CUPERTINO
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State | CA
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Zip | 95014-3027
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Country | US
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Telephone | 408-482-7752
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Fax |
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Provider Business Mailing Address
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Address Line | 3832 MOORPARK AVE APT 1
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City | SAN JOSE
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State | CA
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Zip | 95117-1923
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Country | US
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Telephone | 408-482-7752
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | TIMOTHY R CONLEY
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Credential |
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Telephone | 408-482-7752
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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