Healthcare Provider Details

I. General information

NPI: 1538534979
Provider Name (Legal Business Name): TEMECULA ACUPUNCTURE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2015
Last Update Date: 12/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27450 YNEZ RD SUITE 109
TEMECULA CA
92591-4671
US

IV. Provider business mailing address

27450 YNEZ RD SUITE 109
TEMECULA CA
92591-4671
US

V. Phone/Fax

Practice location:
  • Phone: 951-676-8640
  • Fax:
Mailing address:
  • Phone: 951-676-8640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC10002
License Number StateCA

VIII. Authorized Official

Name: CARRIE L CIMPERMAN
Title or Position: OWNER
Credential: L.AC.
Phone: 951-676-8640