Healthcare Provider Details

I. General information

NPI: 1184886723
Provider Name (Legal Business Name): TIBETAN HEALING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2008
Last Update Date: 10/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4115 3RD AVE
SAN DIEGO CA
92103-1443
US

IV. Provider business mailing address

4115 3RD AVE
SAN DIEGO CA
92103-1443
US

V. Phone/Fax

Practice location:
  • Phone: 619-325-0992
  • Fax:
Mailing address:
  • Phone: 619-325-0992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC11931
License Number StateCA

VIII. Authorized Official

Name: MS. SONDRA M. BUSCHMANN
Title or Position: PRESIDENT
Credential:
Phone: 619-325-0992