1194956557 NPI number — MERIDIAN ACUPUNCTURE

Table of content: (NPI 1194956557)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194956557 NPI number — MERIDIAN ACUPUNCTURE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MERIDIAN ACUPUNCTURE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194956557
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/03/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5043 GRAVES AVE
Provider Second Line Business Mailing Address:
SUITE F
Provider Business Mailing Address City Name:
SAN JOSE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95129-5103
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-551-0788
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
53 CRONIN DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA CLARA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95051-6719
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-984-2455
Provider Business Practice Location Address Fax Number:
408-985-4246
Provider Enumeration Date:
08/03/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LIN
Authorized Official First Name:
CHU
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
408-551-0788

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 171100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)