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General NPI Number Information
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NPI Number | 1962826891
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Entity Type | Organization
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Legal Business Name | DIANE AU, L.AC.
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Dates
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Enumeration Date | 02/12/2014
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Last Update Date | 02/12/2014
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Provider Practice Location Address
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Address Line | 214 DE ANZA BLVD
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City | SAN MATEO
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State | CA
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Zip | 94402-3913
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Country | US
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Telephone | 650-574-1456
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Fax | 650-574-1007
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Provider Business Mailing Address
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Address Line | 214 DE ANZA BLVD
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City | SAN MATEO
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State | CA
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Zip | 94402-3913
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Country | US
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Telephone | 650-574-1456
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Fax | 650-574-1007
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Authorized Official
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Title or Position | OWNER/ACUPUNCTURIST
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Name | DIANE AU
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Credential | L.AC.
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Telephone | 408-833-0353
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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 | AC15243
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License Number State | CA
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