MEDICARE: MISS JAVIS SIU LAN LAU DAOM

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	AC 12311	CA

General Provider Information

NPI Number	:	1689820110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JAVIS SIU LAN LAU DAOM

Provider Business Mailing Address
First Line	:	2060 WALSH AVE
Second Line	:	#133
City	:	SANTA CLARA
State	:	CA
Zip	:	95050-2500
Country	:	US
Telephone Number	:	408-507-4281
Fax Number	:

Provider Business Practice Location Address
First Line	:	6116 CAMINO VERDE DR
Second Line	:	#10
City	:	SAN JOSE
State	:	CA
Zip	:	95119-1441
Country	:	US
Telephone Number	:	408-865-1705
Fax Number	:

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

Provider Enumeration Date	:	08/15/2008
Last Update Date	:	01/29/2014

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