MEDICARE: ACUPOINT ACUPUNCTURE, INC.

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	AC11848	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AC11848	OTHER	CA	STATE PROFESSIONAL LICENSE

General Provider Information

NPI Number	:	1528479680
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACUPOINT ACUPUNCTURE, INC.

Provider Business Mailing Address
First Line	:	20627 GOLDEN SPRINGS DR
Second Line	:	SUITE J
City	:	DIAMOND BAR
State	:	CA
Zip	:	91789-4814
Country	:	US
Telephone Number	:	909-598-1588
Fax Number	:	909-598-1588

Provider Business Practice Location Address
First Line	:	20627 GOLDEN SPRINGS DR
Second Line	:	SUITE J
City	:	DIAMOND BAR
State	:	CA
Zip	:	91789-4814
Country	:	US
Telephone Number	:	909-598-1588
Fax Number	:	909-598-1588

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MAX WEI
Credential	:	L.AC
Telephone Number	:	909-598-1588

Provider Enumeration Date	:	05/12/2014
Last Update Date	:	05/12/2014

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