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NPI 1710112883

NPI 1710112883 : MERISSA TSANG L.AC, DIPL. OM : SAN MATEO, CA

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General NPI Number Information
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    NPI Number           |    1710112883
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    Entity Type          |    Individual 
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    Provider Name        |    MERISSA TSANG L.AC, DIPL. OM
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/19/2009
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    Last Update Date     |    02/11/2022
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Provider Practice Location Address
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    Address Line         |    407 N SAN MATEO DR 
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    City                 |    SAN MATEO
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    State                |    CA
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    Zip                  |    94401-2417
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    Country              |    US
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    Telephone            |    650-576-1350
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    825 SHARON AVE 
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    City                 |    HILLSBOROUGH
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    State                |    CA
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    Zip                  |    94010-6370
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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    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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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 12864
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    License Number State |    CA
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