Healthcare Provider Details

I. General information

NPI: 1710838768
Provider Name (Legal Business Name): TICZON ACUPUNCTURE CLINICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2026
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 E 8TH ST STE 14B
NATIONAL CITY CA
91950-2354
US

IV. Provider business mailing address

550 E 8TH ST STE 14B
NATIONAL CITY CA
91950-2354
US

V. Phone/Fax

Practice location:
  • Phone: 619-855-8273
  • Fax: 619-773-7355
Mailing address:
  • Phone: 619-855-8273
  • Fax: 619-773-7355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: LOURDES R ORTEGA-TICZON
Title or Position: LICENSED ACUPUNCTURIST
Credential: LAC
Phone: 619-855-8273