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General NPI Number Information
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NPI Number | 1093976052
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Entity Type | Organization
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Legal Business Name | KINSELLA ACUPUNCTURE PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 06/23/2008
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | 711 4TH AVE SUITE 201
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City | SAN DIEGO
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State | CA
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Zip | 92101-6970
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Country | US
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Telephone | 619-955-1050
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Fax |
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Provider Business Mailing Address
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Address Line | 711 4TH AVE SUITE 201
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City | SAN DIEGO
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State | CA
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Zip | 92101-6970
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Country | US
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Telephone | 619-955-1050
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CHRISTINE KINSELLA
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Credential | L.AC.
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Telephone | 619-955-1050
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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 | CA11556
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License Number State | CA
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