Healthcare Provider Details

I. General information

NPI: 1942494075
Provider Name (Legal Business Name): THREE TREASURES ACUPUNCTURE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2007
Last Update Date: 08/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4190 BONITA RD SUITE 207
BONITA CA
91902-1329
US

IV. Provider business mailing address

4190 BONITA RD SUITE 207
BONITA CA
91902-1329
US

V. Phone/Fax

Practice location:
  • Phone: 619-267-6050
  • Fax: 619-267-6056
Mailing address:
  • Phone: 619-267-6050
  • Fax: 619-267-6056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. DONNA H KATER
Title or Position: PRESIDENT
Credential: L.AC
Phone: 619-267-6050