Healthcare Provider Details
I. General information
NPI: 1124128152
Provider Name (Legal Business Name): KAREN C SULGER LA.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/22/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
317 N EL CAMINO REAL #401
ENCINITAS CA
92024-2811
US
IV. Provider business mailing address
317 N EL CAMINO REAL #401
ENCINITAS CA
92024-2811
US
V. Phone/Fax
- Phone: 760-635-0581
- Fax: 760-635-0587
- Phone: 760-635-0581
- Fax: 760-635-0587
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | CA5573 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: