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General NPI Number Information
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NPI Number | 1306323274
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Entity Type | Organization
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Legal Business Name | MATRU-SPARSH ACUPUNCTURE HEATH AND WELLNESS CLINIC INC
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Dates
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Enumeration Date | 07/24/2018
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Last Update Date | 07/24/2018
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Provider Practice Location Address
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Address Line | 888 CHANNEL ISLAND DR
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City | ENCINITAS
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State | CA
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Zip | 92024-2484
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Country | US
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Telephone | 858-692-4726
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Fax |
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Provider Business Mailing Address
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Address Line | 888 CHANNEL ISLAND DR
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City | ENCINITAS
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State | CA
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Zip | 92024-2484
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Country | US
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Telephone | 858-692-4726
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | NAMRATA CHANSARKAR
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Credential | LA.C.
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Telephone | 949-294-1490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | AC18127
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License Number State | CA
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