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General NPI Number Information
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NPI Number | 1386426799
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Entity Type | Organization
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Legal Business Name | AVA ZACK ACUPUNCTURE INC
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Dates
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Enumeration Date | 10/19/2023
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 1537 PACIFIC AVE STE 300H
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City | SANTA CRUZ
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State | CA
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Zip | 95060-3982
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Country | US
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Telephone | 831-401-5141
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Fax | 831-401-5143
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Provider Business Mailing Address
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Address Line | PO BOX 5671
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City | SANTA CRUZ
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State | CA
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Zip | 95063-5671
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Country | US
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Telephone | 831-345-1244
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | AVA ZACK
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Credential | LAC, DIPL.OM., CMTPT
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Telephone | 831-345-1244
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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 |
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License Number State |
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