MEDICARE: TING TING HSIA LAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AC14593	CA

General Provider Information

NPI Number	:	1104199785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TING TING HSIA LAC

Provider Business Mailing Address
First Line	:	3288 PIERCE ST, C-121
Second Line	:
City	:	RICHMOND
State	:	CA
Zip	:	94803-1152
Country	:	US
Telephone Number	:	510-559-8897
Fax Number	:

Provider Business Practice Location Address
First Line	:	3288 PIERCE ST, C-121
Second Line	:
City	:	RICHMOND
State	:	CA
Zip	:	94803-1152
Country	:	US
Telephone Number	:	510-559-8897
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2012
Last Update Date	:	09/01/2012

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