Provider Demographics
NPI:1588988893
Name:MORRISSEY, DONG HAN (ACUPUNCTURIST)
Entity type:Individual
Prefix:PROF
First Name:DONG
Middle Name:HAN
Last Name:MORRISSEY
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10601 S DE ANZA BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-4451
Mailing Address - Country:US
Mailing Address - Phone:408-252-8088
Mailing Address - Fax:408-252-8088
Practice Address - Street 1:10601 S DE ANZA BLVD STE 103
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-4451
Practice Address - Country:US
Practice Address - Phone:408-252-8088
Practice Address - Fax:408-252-8088
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-16
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 7962171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAN/AOtherN/A