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General NPI Number Information
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NPI Number | 1528345907
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Entity Type | Individual
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Provider Name | CHRISTOPHER HARRISON RUTH DAOM, LAC
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Gender | Male
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Dates
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Enumeration Date | 11/13/2011
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Last Update Date | 09/19/2022
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Provider Practice Location Address
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Address Line | 1807 WILSHIRE BLVD STE 200
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City | SANTA MONICA
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State | CA
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Zip | 90403-5795
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Country | US
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Telephone | 424-268-8552
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Fax |
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Provider Business Mailing Address
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Address Line | 1501 S. LOOP 288 STE 104 PMB #105
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City | DENTON
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State | TX
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Zip | 76205
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Country | US
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Telephone | 310-819-0225
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 14416
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License Number State | CA
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