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General NPI Number Information
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NPI Number | 1790198075
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Entity Type | Organization
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Legal Business Name | DINA FIDEL ACUPUNCTURE INC
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Dates
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Enumeration Date | 06/04/2014
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Last Update Date | 06/04/2014
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Provider Practice Location Address
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Address Line | 167 E FREMONT AVE
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City | SUNNYVALE
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State | CA
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Zip | 94087-2501
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Country | US
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Telephone | 408-481-4763
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Fax |
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Provider Business Mailing Address
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Address Line | 167 E FREMONT AVE
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City | SUNNYVALE
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State | CA
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Zip | 94087-2501
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Country | US
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Telephone | 408-481-4763
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DINA FIDEL
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Credential | L.AC.
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Telephone | 408-481-4763
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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 | AC7658
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License Number State | CA
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