Healthcare Provider Details

I. General information

NPI: 1326326422
Provider Name (Legal Business Name): ANH TRANG L.AC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2011
Last Update Date: 07/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 EL CAJON BLVD STE 206
LA MESA CA
91942-7416
US

IV. Provider business mailing address

7106 AMHERST ST
SAN DIEGO CA
92115-3052
US

V. Phone/Fax

Practice location:
  • Phone: 619-319-7705
  • Fax:
Mailing address:
  • Phone: 619-319-7705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number13807
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: