MEDICARE: MRS. JANE TONG DELORE L.AC.

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	AC15226	CA

General Provider Information

NPI Number	:	1538595988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JANE TONG DELORE L.AC.

Provider Business Mailing Address
First Line	:	23 MOORE CT
Second Line	:
City	:	ALAMEDA
State	:	CA
Zip	:	94502-7744
Country	:	US
Telephone Number	:	510-863-0189
Fax Number	:	510-814-8809

Provider Business Practice Location Address
First Line	:	2229 SANTA CLARA AVE STE B
Second Line	:
City	:	ALAMEDA
State	:	CA
Zip	:	94501-4409
Country	:	US
Telephone Number	:	510-863-0189
Fax Number	:	510-814-8809

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

Provider Enumeration Date	:	09/17/2013
Last Update Date	:	09/09/2020

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