Healthcare Provider Details

I. General information

NPI: 1104323054
Provider Name (Legal Business Name): MARQUE ACUPUNCTURE & MICRONEEDLING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2018
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27625 JEFFERSON AVE STE 105B
TEMECULA CA
92590-2619
US

IV. Provider business mailing address

27625 JEFFERSON AVE STE 105B
TEMECULA CA
92590-2619
US

V. Phone/Fax

Practice location:
  • Phone: 818-818-8299
  • Fax:
Mailing address:
  • Phone: 818-818-8299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC14045
License Number StateCA

VIII. Authorized Official

Name: MR. JOACHIM MARQUE
Title or Position: OWNER / ACUPUNCTURIST
Credential: L.AC.
Phone: 818-818-8299