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General NPI Number Information
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NPI Number | 1316701600
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Entity Type | Individual
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Provider Name | KYONG-MI ROXANNE ARCALA DILLARD CMT
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Gender | Female
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Dates
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Enumeration Date | 02/08/2024
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Last Update Date | 02/08/2024
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Provider Practice Location Address
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Address Line | 6480 E PACIFIC COAST HWY STE 150
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City | LONG BEACH
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State | CA
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Zip | 90803-4261
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Country | US
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Telephone | 562-451-4038
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Fax |
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Provider Business Mailing Address
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Address Line | 16761 VIEWPOINT LN APT 360
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-4788
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Country | US
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Telephone | 971-209-9821
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 3199
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License Number State | CA
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