MEDICARE: ORIENTAL ACUPUNCTURE WELLNESS CENTER

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

General Provider Information

NPI Number	:	1437783362
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORIENTAL ACUPUNCTURE WELLNESS CENTER

Provider Business Mailing Address
First Line	:	1111 W EL CAMINO REAL STE 121
Second Line	:
City	:	SUNNYVALE
State	:	CA
Zip	:	94087-1057
Country	:	US
Telephone Number	:	408-962-0275
Fax Number	:

Provider Business Practice Location Address
First Line	:	1111 W EL CAMINO REAL STE 121
Second Line	:
City	:	SUNNYVALE
State	:	CA
Zip	:	94087-1057
Country	:	US
Telephone Number	:	408-962-0275
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	HUGH B LEE
Credential	:
Telephone Number	:	408-962-0275

Provider Enumeration Date	:	02/29/2020
Last Update Date	:	02/29/2020

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