MEDICARE: MR. DANBO ZHAO ACUPUNCTURIST

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	AC6781	CA

General Provider Information

NPI Number	:	1639333248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DANBO ZHAO ACUPUNCTURIST

Provider Business Mailing Address
First Line	:	10990 WARNER AVE
Second Line	:	SUITE B
City	:	FOUNTAIN VALLEY
State	:	CA
Zip	:	92708-3849
Country	:	US
Telephone Number	:	714-593-8881
Fax Number	:	714-593-8882

Provider Business Practice Location Address
First Line	:	10990 WARNER AVE
Second Line	:	SUITE B
City	:	FOUNTAIN VALLEY
State	:	CA
Zip	:	92708-3849
Country	:	US
Telephone Number	:	714-593-8881
Fax Number	:	714-593-8882

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

Provider Enumeration Date	:	07/12/2008
Last Update Date	:	07/12/2008

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