=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922561620
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | B&H ACUPUNCTURE SERVICES, CORP.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/09/2019
-----------------------------------------------------
Last Update Date | 04/09/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2209 IRVING ST
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94122-1618
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-413-6325
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2209 IRVING ST
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94122-1618
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-413-6325
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ACUPUNCTURIST
-----------------------------------------------------
Name | CHENGJUN XU
-----------------------------------------------------
Credential | L.AC
-----------------------------------------------------
Telephone | 415-413-6325
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------