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General NPI Number Information
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NPI Number | 1457829301
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Entity Type | Organization
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Legal Business Name | DIAMOND HEALING ACUPUNCTURE INC
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Dates
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Enumeration Date | 11/08/2018
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Last Update Date | 11/08/2018
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Provider Practice Location Address
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Address Line | 4441 SEPULVEDA BLVD
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City | CULVER CITY
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State | CA
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Zip | 90230-4847
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Country | US
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Telephone | 424-258-0858
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Fax |
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Provider Business Mailing Address
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Address Line | 5215 SEPULVEDA BLVD UNIT 13C
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City | CULVER CITY
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State | CA
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Zip | 90230-5246
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Country | US
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Telephone | 424-258-0858
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | AMY DIAMOND
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Credential | L.AC.
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Telephone | 424-258-0858
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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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