MEDICARE: ACTIVE ACUPUNCTURE PARTNERS 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	AC11508	CA

General Provider Information

NPI Number	:	1538484431
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACTIVE ACUPUNCTURE PARTNERS INC.

Provider Business Mailing Address
First Line	:	18988 COX AVE
Second Line	:	SUITE C
City	:	SARATOGA
State	:	CA
Zip	:	95070-4154
Country	:	US
Telephone Number	:	408-621-5332
Fax Number	:	888-887-5012

Provider Business Practice Location Address
First Line	:	18988 COX AVE
Second Line	:	SUITE C
City	:	SARATOGA
State	:	CA
Zip	:	95070-4154
Country	:	US
Telephone Number	:	408-621-5332
Fax Number	:	888-887-5012

Authorized Official
Title or Position	:	L.AC.
Name	:	JUN CAO
Credential	:
Telephone Number	:	408-621-5332

Provider Enumeration Date	:	04/02/2010
Last Update Date	:	09/21/2010

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95070-4154

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1285772152 — DR. FRANK RICHARD NOODLEMAN M.D.
Practice Location Address:

18988 COX AVE
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95070-4154

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1801004650 — DR. KATHARINE BALL M.D.
Practice Location Address:

18988 COX AVE STE B
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1780821223 — MS. LISA KAR YING WONG L. AC.
Practice Location Address:

18988 COX AVE STE C
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