=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710865274
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PIVOTAL MERIDIAN UNIVERSITY ACUPUNCTURE CLINIC INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/23/2025
-----------------------------------------------------
Last Update Date | 08/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 710 LAKEWAY DR STE 230
-----------------------------------------------------
City | SUNNYVALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94085-4046
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-931-1109
-----------------------------------------------------
Fax | 415-873-3288
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 710 LAKEWAY DR STE 230
-----------------------------------------------------
City | SUNNYVALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94085-4046
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-931-1109
-----------------------------------------------------
Fax | 415-873-3288
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | YA-FEN CHEN
-----------------------------------------------------
Credential | ACUPUNCTURIST
-----------------------------------------------------
Telephone | 408-931-1109
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------