Organization Active NPI

Institute for Traditional Acupuncture and Herbology

  • Acupuncturist
  • Corte Madera, CA
National Provider Identifier
1255407235
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC 10122 Issued in CA
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

Updated by the provider on Sep 11, 2025

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)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X AC 970 CA
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X AC 4943 CA
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X AC 10122 CA Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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 Directory

NPI 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.

Verify at the official NPI Registry.