MEDICARE: TINY NEEDLES

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		CA

General Provider Information

NPI Number	:	1225577604
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TINY NEEDLES

Provider Business Mailing Address
First Line	:	1808 MCALLISTER ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94115-4321
Country	:	US
Telephone Number	:	415-409-1506
Fax Number	:

Provider Business Practice Location Address
First Line	:	1808 MCALLISTER ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94115-4321
Country	:	US
Telephone Number	:	415-409-1506
Fax Number	:

Authorized Official
Title or Position	:	CLINIC MANAGER
Name	:	MRS. WILMA GOODYEAR
Credential	:
Telephone Number	:	415-409-1506

Provider Enumeration Date	:	02/17/2017
Last Update Date	:	02/17/2017

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Directions to “TINY NEEDLES ” Practice Location

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