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General NPI Number Information
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NPI Number | 1205060126
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Entity Type | Organization
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Legal Business Name | ACUPUNCTURE HEALTHCARE INC.
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Dates
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Enumeration Date | 05/06/2009
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Last Update Date | 05/06/2009
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Provider Practice Location Address
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Address Line | 5445 OBERLIN DR SUITE # 101
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City | SAN DIEGO
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State | CA
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Zip | 92121-1704
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Country | US
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Telephone | 858-458-0625
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Fax |
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Provider Business Mailing Address
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Address Line | 5445 OBERLIN DR SUITE # 101
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City | SAN DIEGO
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State | CA
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Zip | 92121-1704
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Country | US
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Telephone | 858-458-0625
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Fax |
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Authorized Official
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Title or Position | C.E.O.
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Name | DR. RON CLYDE LORD JR.
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Credential | LAC. O.M.D.
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Telephone | 858-458-0625
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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 | LAC9362
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License Number State | CA
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