MEDICARE: TUNAN PENG 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	AC14868	CA

General Provider Information

NPI Number	:	1548523350
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TUNAN PENG L.AC

Provider Business Mailing Address
First Line	:	2004 UNIVERSITY AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95128-1432
Country	:	US
Telephone Number	:	650-533-8598
Fax Number	:

Provider Business Practice Location Address
First Line	:	1289 E HILLSDALE BLVD STE 2
Second Line	:
City	:	FOSTER CITY
State	:	CA
Zip	:	94404-1219
Country	:	US
Telephone Number	:	650-533-8598
Fax Number	:

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

Provider Enumeration Date	:	06/18/2012
Last Update Date	:	06/18/2012

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Directions to “ TUNAN PENG L.AC” Practice Location

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