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General NPI Number Information
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NPI Number | 1346514205
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Entity Type | Organization
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Legal Business Name | THE MERIDIAN CENTER
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Dates
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Enumeration Date | 02/23/2012
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Last Update Date | 02/23/2012
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Provider Practice Location Address
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Address Line | 506 SANTA MONICA BLVD SUITE 227
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City | SANTA MONICA
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State | CA
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Zip | 90401-2434
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Country | US
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Telephone | 310-395-9525
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Fax | 310-395-9022
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Provider Business Mailing Address
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Address Line | 506 SANTA MONICA BLVD SUITE 227
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City | SANTA MONICA
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State | CA
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Zip | 90401-2434
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Country | US
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Telephone | 310-395-9525
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Fax | 310-395-9022
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Authorized Official
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Title or Position | PRINCIPLE
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Name | JULIAN LANGE
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Credential | OMD, LAC
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Telephone | 310-395-9525
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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 | AC1450
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License Number State | CA
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