# INSTITUTE FOR TRADITIONAL ACUPUNCTURE AND HERBOLOGY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255407235
- **Authorized official:** MR. MIKI SHIMA N.D., O.M.D., L.AC. (PRESIDENT)
- **Authorized official phone:** (415) 924-2910

## Contact information

- **Practice address:** 21 TAMAL VISTA BLVD, SUITE 110, CORTE MADERA, CA 94925-1130
- **Practice address phone:** (415) 924-2910
- **Practice address fax:** (415) 924-5072
- **Mailing address:** 21 TAMAL VISTA BLVD, SUITE 110, CORTE MADERA, CA 94925-1130
- **Mailing address phone:** (415) 924-2910
- **Mailing address fax:** (415) 924-5072

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | AC 10122 | CA | Yes |
| 171100000X | Acupuncturist | AC 4943 | CA | — |
| 171100000X | Acupuncturist | AC 970 | CA | — |
| 207R00000X | Internal Medicine Physician | G62455 | CA | — |

## Other

- **Enumeration date:** 11/28/2006
- **Last updated:** 09/11/2025