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General NPI Number Information
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NPI Number | 1710733100
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Entity Type | Organization
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Legal Business Name | MAHJONG ACUPUNCTURE AND TRADITIONAL CHINESE MEDICINE, INC.
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Dates
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Enumeration Date | 04/25/2024
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 1399 S WINCHESTER BLVD STE 140
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City | SAN JOSE
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State | CA
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Zip | 95128-4342
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Country | US
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Telephone | 408-261-0766
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Fax |
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Provider Business Mailing Address
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Address Line | 550 E WEDDELL DR UNIT 4202
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City | SUNNYVALE
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State | CA
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Zip | 94089-2373
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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 | PRESIDENT AND CEO
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Name | DR. KEVIN TAI
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Credential | DTCM, L.AC.
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Telephone | 669-588-4567
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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 |
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License Number State |
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