Provider Demographics
NPI:1285381160
Name:MORISHIGE ACUPUNCTURE, FUNCTIONAL MEDICINE & HERBAL PHARMACY
Entity type:Organization
Organization Name:MORISHIGE ACUPUNCTURE, FUNCTIONAL MEDICINE & HERBAL PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORISHIGE
Authorized Official - Suffix:
Authorized Official - Credentials:DOM, CFMP, RX, CPT
Authorized Official - Phone:505-690-3777
Mailing Address - Street 1:2641 HENRY AVE
Mailing Address - Street 2:
Mailing Address - City:PINOLE
Mailing Address - State:CA
Mailing Address - Zip Code:94564-1358
Mailing Address - Country:US
Mailing Address - Phone:505-690-3777
Mailing Address - Fax:
Practice Address - Street 1:1417 SANTA CRUZ DR
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-3861
Practice Address - Country:US
Practice Address - Phone:505-690-3777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty