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General NPI Number Information
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NPI Number | 1447001300
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Entity Type | Organization
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Legal Business Name | PCC ACUPUNCTURE GROUP
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Dates
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Enumeration Date | 03/28/2024
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Last Update Date | 03/28/2024
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Provider Practice Location Address
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Address Line | 31740 RAILROAD CANYON RD STE 3
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City | CANYON LAKE
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State | CA
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Zip | 92587-9490
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Country | US
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Telephone | 951-244-7676
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Fax | 951-244-5757
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Provider Business Mailing Address
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Address Line | 31740 RAILROAD CANYON RD STE 3
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City | CANYON LAKE
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State | CA
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Zip | 92587-9490
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Country | US
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Telephone | 951-244-7676
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Fax | 951-244-5757
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | DR. TINA YAN LI
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Credential | PHD
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Telephone | 951-244-7676
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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 |
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License Number State |
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