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General NPI Number Information
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NPI Number | 1205239258
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Entity Type | Individual
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Provider Name | THOMAS CHARLES FLACH JR. L.AC.
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Gender | Male
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Dates
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Enumeration Date | 10/06/2014
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 29135 HOOK CREEK RD
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City | CEDAR GLEN
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State | CA
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Zip | 92321
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Country | US
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Telephone | 858-761-7432
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1186
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City | CEDAR GLEN
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State | CA
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Zip | 92321-1186
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Country | US
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Telephone | 858-760-7432
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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 | AC11773
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License Number State | CA
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