Healthcare Provider Details
I. General information
NPI: 1619881893
Provider Name (Legal Business Name): ACUPUNCTURE FOR MIND & BODY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12243 POWAY RD
POWAY CA
92064-4217
US
IV. Provider business mailing address
12243 POWAY RD
POWAY CA
92064-4217
US
V. Phone/Fax
- Phone: 858-261-8038
- Fax: 858-380-4248
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | NULL |
VIII. Authorized Official
Name: MS.
PIN
LU
Title or Position: ACUPUNCTURIST
Credential:
Phone: 858-261-8038