Active NPI
Institute for Traditional Acupuncture and Herbology
- Acupuncturist
- Corte Madera, CA
National Provider Identifier
1255407235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC 10122
- Legal business name
- INSTITUTE FOR TRADITIONAL ACUPUNCTURE AND HERBOLOGY
- Practice address
- 21 Tamal Vista Blvd
Suite 110
Corte Madera, CA 94925-1130 - Phone
- (415) 924-2910
- Fax
- (415) 924-5072
- NPI assigned
- Nov 28, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Miki Shima, N.D., O.M.D., L.AC.
- Title
- President
- Phone
- (415) 924-2910
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC 970 | CA | |
| Acupuncturist | 171100000X | AC 4943 | CA | |
| Acupuncturist | 171100000X | AC 10122 | CA | Primary |
| Internal Medicine Physician | 207R00000X | G62455 | CA |
Addresses
Primary practice location
21 Tamal Vista Blvd
Suite 110
Corte Madera, CA 94925-1130
Mailing address
21 Tamal Vista Blvd
Suite 110
Corte Madera, CA 94925-1130
Phone (415) 924-2910
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1255407235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 TAMAL VISTA BLVD",
"address_2": "SUITE 110",
"city": "CORTE MADERA",
"state": "CA",
"postal_code": "949251130",
"telephone_number": "415-924-2910",
"fax_number": "415-924-5072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 TAMAL VISTA BLVD",
"address_2": "SUITE 110",
"city": "CORTE MADERA",
"state": "CA",
"postal_code": "949251130",
"telephone_number": "415-924-2910",
"fax_number": "415-924-5072"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INSTITUTE FOR TRADITIONAL ACUPUNCTURE AND HERBOLOGY",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-28",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "SHIMA",
"authorized_official_first_name": "MIKI",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "415-924-2910",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "N.D., O.M.D., L.AC."
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC 970",
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC 4943",
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC 10122",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "CA",
"license": "G62455",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Corte Madera, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.