Healthcare Provider Details

I. General information

NPI: 1003211541
Provider Name (Legal Business Name): CHRISTOPHER VEIGA L.AC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2014
Last Update Date: 10/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

465 MILLER AVE
MILL VALLEY CA
94941-2941
US

IV. Provider business mailing address

465 MILLER AVE
MILL VALLEY CA
94941-2941
US

V. Phone/Fax

Practice location:
  • Phone: 415-383-9900
  • Fax:
Mailing address:
  • Phone: 415-383-9900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC8401
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: