Healthcare Provider Details

I. General information

NPI: 1972934826
Provider Name (Legal Business Name): JOHN PHILIP OHARA L.AC. DIPL. OM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2013
Last Update Date: 01/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2335 ATHENS AVE
REDDING CA
96001-2818
US

IV. Provider business mailing address

2650 OXFORD RD APARTMENT 2
REDDING CA
96002-1342
US

V. Phone/Fax

Practice location:
  • Phone: 310-977-4019
  • Fax:
Mailing address:
  • Phone: 310-977-4019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number15485
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: