Healthcare Provider Details

I. General information

NPI: 1841724952
Provider Name (Legal Business Name): ACULIFE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2017
Last Update Date: 04/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 VILLA LA JOLLA DR SUITE B212
LA JOLLA CA
92037-1714
US

IV. Provider business mailing address

8950 VILLA LA JOLLA DR SUITE B212
LA JOLLA CA
92037-1714
US

V. Phone/Fax

Practice location:
  • Phone: 858-210-0969
  • Fax:
Mailing address:
  • Phone: 858-210-0969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number13701
License Number StateCA

VIII. Authorized Official

Name: JULIA ROBAR
Title or Position: ACUPUNCTURIST / OWNER
Credential: L.AC
Phone: 858-210-0969