Healthcare Provider Details

I. General information

NPI: 1619183530
Provider Name (Legal Business Name): ACUPUNCTURE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15644 POMERADO RD STE 102
POWAY CA
92064
US

IV. Provider business mailing address

15644 POMERADO RD STE 102
POWAY CA
92064-2419
US

V. Phone/Fax

Practice location:
  • Phone: 858-613-0792
  • Fax: 858-613-0794
Mailing address:
  • Phone: 858-613-0792
  • Fax: 858-613-0794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC 7440
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC 6958
License Number StateCA

VIII. Authorized Official

Name: MICHELE MARY ARNOLD
Title or Position: ACUPUNCTURIST
Credential: L.AC.
Phone: 858-613-0792