Basic Information
| Provider Information | |||||||||
| NPI: | 1396293171 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | POSITIVE TONE ACUPUNCTURE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 POLLARD RD STE B203 | ||||||||
| Address2: | |||||||||
| City: | LOS GATOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950321429 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4084095005 | ||||||||
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| Practice Location | |||||||||
| Address1: | 800 POLLARD RD STE B203 | ||||||||
| Address2: | |||||||||
| City: | LOS GATOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950321429 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4084095005 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2016 | ||||||||
| LastUpdateDate: | 09/21/2016 | ||||||||
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| AuthorizedOfficialLastName: | TRATENG | ||||||||
| AuthorizedOfficialFirstName: | KAMOLLUCK | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4084095005 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | L.AC. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171100000X | AC16450 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Acupuncturist |
No ID Information.