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General NPI Number Information
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NPI Number | 1053750182
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Entity Type | Individual
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Provider Name | DONNA VEGA L. AC., DIPL. O. M.
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Gender | Female
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Dates
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Enumeration Date | 06/21/2013
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Last Update Date | 03/08/2016
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Provider Practice Location Address
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Address Line | 2001 S BARRINGTON AVE
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City | LOS ANGELES
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State | CA
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Zip | 90025-5363
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Country | US
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Telephone | 310-883-4446
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Fax |
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Provider Business Mailing Address
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Address Line | 2447 WALNUT AVE
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City | VENICE
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State | CA
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Zip | 90291-5043
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Country | US
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Telephone | 310-993-2714
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 15166
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License Number State | CA
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