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General NPI Number Information
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NPI Number | 1477818433
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Entity Type | Organization
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Legal Business Name | PREFERRED ACUPUNCTURE CENTER
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Dates
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Enumeration Date | 07/05/2012
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Last Update Date | 07/05/2012
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Provider Practice Location Address
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Address Line | 1071 BROADWAY STE 112
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City | CHULA VISTA
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State | CA
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Zip | 91911-7823
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Country | US
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Telephone | 619-500-5639
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Fax | 888-515-1752
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Provider Business Mailing Address
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Address Line | 1071 BROADWAY STE 112
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City | CHULA VISTA
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State | CA
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Zip | 91911-7823
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Country | US
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Telephone | 619-500-5639
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Fax | 888-515-1752
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Authorized Official
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Title or Position | DIRECTOR
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Name | SERGIO CONTI
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Credential |
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Telephone | 619-719-3488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 070687
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License Number State | CA
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