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General NPI Number Information
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NPI Number | 1861784621
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Entity Type | Individual
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Provider Name | JEAN-LOUIS RICHIARDONE MS, L.AC.
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Gender | Male
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Dates
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Enumeration Date | 05/11/2011
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Last Update Date | 03/15/2012
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Provider Practice Location Address
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Address Line | 645 TAMALPAIS DR SUITE D
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City | CORTE MADERA
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State | CA
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Zip | 94925-1613
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Country | US
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Telephone | 415-236-3993
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Fax |
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Provider Business Mailing Address
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Address Line | 645 TAMALPAIS DR SUITE D
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City | CORTE MADERA
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State | CA
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Zip | 94925-1613
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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 | AC14215
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License Number State | CA
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