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General NPI Number Information
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NPI Number | 1215222088
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Entity Type | Organization
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Legal Business Name | LOTUS WELLNESS ACUPUNCTURE INC
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Dates
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Enumeration Date | 06/09/2011
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Last Update Date | 06/09/2011
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Provider Practice Location Address
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Address Line | 900 E LINCOLN AVE
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City | ORANGE
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State | CA
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Zip | 92865-1905
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Country | US
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Telephone | 714-637-6370
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Fax | 714-637-2744
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Provider Business Mailing Address
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Address Line | 900 E LINCOLN AVE
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City | ORANGE
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State | CA
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Zip | 92865-1905
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Country | US
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Telephone | 714-637-6370
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Fax | 714-637-2744
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DR. DEEPAK MOOSAD
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Credential | D.C.
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Telephone | 714-637-6370
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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 | 11790
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 31690
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License Number State | CA
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