=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649723040
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | L S W P
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/02/2016
-----------------------------------------------------
Last Update Date | 05/08/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11939 RANCHO BERNARDO RD STE 105
-----------------------------------------------------
City | SAN DIEGO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92128-2073
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-786-7579
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11939 RANCHO BERNARDO RD STE 105
-----------------------------------------------------
City | SAN DIEGO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92128-2073
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-786-7579
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | MARGARET LIN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 619-786-7579
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | 10638
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------