Healthcare Provider Details

I. General information

NPI: 1255209045
Provider Name (Legal Business Name): MC ACUPUNCTURE GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2025
Last Update Date: 10/24/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 S. ALLIED WAY
EL SEGUNDO CA
90245
US

IV. Provider business mailing address

645 S. ALLIED WAY
EL SEGUNDO CA
90245
US

V. Phone/Fax

Practice location:
  • Phone: 310-395-8363
  • Fax:
Mailing address:
  • Phone: 310-395-8363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: MURRAY COLIN CLARKE
Title or Position: PRACTITIONER
Credential: L.AC.
Phone: 310-395-8363