=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851753016
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ZEN ACUPUNCTURE INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/25/2016
-----------------------------------------------------
Last Update Date | 03/25/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1780 TOWN AND COUNTRY DR SUITE A-102
-----------------------------------------------------
City | NORCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92860-3617
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-270-0036
-----------------------------------------------------
Fax | 951-270-0023
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1780 TOWN AND COUNTRY DR SUITE A-102
-----------------------------------------------------
City | NORCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92860-3617
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-270-0036
-----------------------------------------------------
Fax | 951-270-0023
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ACUPUNCTURIST
-----------------------------------------------------
Name | MISS SEHEE JOE
-----------------------------------------------------
Credential | LAC
-----------------------------------------------------
Telephone | 951-270-0036
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------