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General NPI Number Information
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NPI Number | 1578012639
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Entity Type | Organization
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Legal Business Name | ADVANCED ACUPUNCTURE & WELLNESS CENTER
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Dates
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Enumeration Date | 09/29/2016
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Last Update Date | 10/04/2016
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Provider Practice Location Address
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Address Line | 40055 BOB HOPE DR STE H
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-3940
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Country | US
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Telephone | 760-832-7585
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Fax | 760-832-7172
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Provider Business Mailing Address
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Address Line | 40055 BOB HOPE DR STE H
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-3940
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Country | US
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Telephone | 760-832-7585
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEPHANIE H. LEE
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Credential | PH. D ,
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Telephone | 760-832-7585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | AC16316
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License Number State | CA
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