Healthcare Provider Details

I. General information

NPI: 1104749738
Provider Name (Legal Business Name): LOUISE MAGGAY LAC, DACCHM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 CAMINO DEL RIO S STE 320
SAN DIEGO CA
92108-3837
US

IV. Provider business mailing address

3333 CAMINO DEL RIO S STE 320
SAN DIEGO CA
92108-3837
US

V. Phone/Fax

Practice location:
  • Phone: 619-571-6895
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number96481
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number20690
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: