MEDICARE: LUMINA ZEN ACUPUNCTURE INC

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

General Provider Information

NPI Number	:	1700722485
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUMINA ZEN ACUPUNCTURE INC

Provider Business Mailing Address
First Line	:	20735 STEVENS CREEK BLVD STE B
Second Line	:
City	:	CUPERTINO
State	:	CA
Zip	:	95014-2198
Country	:	US
Telephone Number	:	650-766-8718
Fax Number	:

Provider Business Practice Location Address
First Line	:	20735 STEVENS CREEK BLVD STE B
Second Line	:
City	:	CUPERTINO
State	:	CA
Zip	:	95014-2198
Country	:	US
Telephone Number	:	650-766-8718
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	XIAODAN LI
Credential	:
Telephone Number	:	650-766-8718

Provider Enumeration Date	:	04/27/2026
Last Update Date	:	04/27/2026

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