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General NPI Number Information
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NPI Number | 1053235895
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Entity Type | Organization
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Legal Business Name | POKE-AHA-NTAS ACUPUNCTURE, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 08/05/2026
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Last Update Date | 08/05/2026
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Provider Practice Location Address
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Address Line | 5755 OBERLIN DR STE 316A
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City | SAN DIEGO
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State | CA
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Zip | 92121-1786
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Country | US
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Telephone | 619-800-8492
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Fax |
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Provider Business Mailing Address
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Address Line | 7740 PARKWAY DR UNIT 207
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City | LA MESA
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State | CA
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Zip | 91942-4611
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LARA DANIELLE GROSSMITH
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Credential | DACCHM, L.AC.
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Telephone | 619-800-8492
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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