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General NPI Number Information
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NPI Number | 1336378504
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Entity Type | Organization
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Legal Business Name | ACUPUNCTURE THERAPEUTICS
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Dates
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Enumeration Date | 07/09/2009
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Last Update Date | 10/26/2017
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Provider Practice Location Address
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Address Line | 1224 EAST GREEN ST SUITE 100
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City | PASADENA
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State | CA
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Zip | 91106
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Country | US
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Telephone | 626-755-6260
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Fax | 626-628-3151
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Provider Business Mailing Address
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Address Line | 3320 HENRIETTA AVE
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City | LA CRESENTA
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State | CA
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Zip | 91214
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Country | US
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Telephone | 626-755-6260
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Fax | 626-628-3151
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | KATARINA RYAN
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Credential | L.AC.
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Telephone | 323-333-2835
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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 | 13068
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License Number State | CA
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