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General NPI Number Information
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NPI Number | 1972732394
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Entity Type | Organization
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Legal Business Name | ANTO ACUPUNCTURE & CHINESE MEDICINE CLINIC,INC
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Dates
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Enumeration Date | 07/07/2009
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Last Update Date | 07/07/2009
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Provider Practice Location Address
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Address Line | 20445 PACIFICA DR SUITE A 1
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City | CUPERTINO
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State | CA
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Zip | 95014
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Country | US
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Telephone | 408-996-7358
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Fax | 408-996-7358
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Provider Business Mailing Address
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Address Line | P.O. BOX 2003
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City | CUPERTINO
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State | CA
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Zip | 95015-2003
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Country | US
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Telephone | 408-996-7358
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Fax | 408-996-7358
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Authorized Official
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Title or Position | CEO
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Name | DR. HIDENORI ANTO
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Credential | L.AC
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Telephone | 408-996-7358
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 3148329
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License Number State | CA
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