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General NPI Number Information
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NPI Number | 1194864264
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Entity Type | Individual
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Provider Name | ALITA ALDRIDGE L.AC.
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Gender | Female
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5764 RODEO RD
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City | LOS ANGELES
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State | CA
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Zip | 90016-5040
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Country | US
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Telephone | 323-294-9550
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Fax |
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Provider Business Mailing Address
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Address Line | 5358 SANCHEZ DR
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City | LOS ANGELES
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State | CA
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Zip | 90008-1140
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Country | US
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Telephone | 323-294-9550
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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 | AC3728
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License Number State | CA
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