Healthcare Provider Details

I. General information

NPI: 1689077869
Provider Name (Legal Business Name): ARC HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2014
Last Update Date: 10/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2636 WORDEN ST UNIT 131
SAN DIEGO CA
92110-5844
US

IV. Provider business mailing address

3495 CAMINO DEL RIO SOUTH SUITE 307
SAN DIEGO CA
92108
US

V. Phone/Fax

Practice location:
  • Phone: 619-591-8452
  • Fax:
Mailing address:
  • Phone: 619-591-8452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: ANTONY Y LIM
Title or Position: CLINIC DIRECTOR
Credential: LAC
Phone: 619-591-8452