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General NPI Number Information
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NPI Number | 1376912832
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Entity Type | Organization
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Legal Business Name | CENTER OF NATURAL MEDICINE
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Dates
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Enumeration Date | 09/15/2015
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Last Update Date | 09/15/2015
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Provider Practice Location Address
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Address Line | 25405 HANCOCK AVE STE 104
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City | MURRIETA
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State | CA
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Zip | 92562-5983
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Country | US
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Telephone | 951-587-7265
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Fax | 951-894-5228
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Provider Business Mailing Address
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Address Line | 25405 HANCOCK AVE STE 104
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City | MURRIETA
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State | CA
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Zip | 92562-5983
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Country | US
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Telephone | 951-587-7265
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Fax | 951-894-5228
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Authorized Official
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Title or Position | CHAIRMAN
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Name | DEBBIE A SUH
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Credential | L.AC
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Telephone | 951-587-7265
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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 | AC14413
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License Number State | CA
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