MEDICARE: LINDA ZONG MOUACHEUPAO DCM

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	2018	MN

General Provider Information

NPI Number	:	1548999865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA ZONG MOUACHEUPAO DCM

Provider Business Mailing Address
First Line	:	6100 SUMMIT DR N APT 313
Second Line	:
City	:	BROOKLYN CENTER
State	:	MN
Zip	:	55430-5100
Country	:	US
Telephone Number	:	347-433-3611
Fax Number	:

Provider Business Practice Location Address
First Line	:	4748 CHICAGO AVE STE 21
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-4320
Country	:	US
Telephone Number	:	612-361-9160
Fax Number	:

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

Provider Enumeration Date	:	06/10/2022
Last Update Date	:	06/10/2022

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