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General NPI Number Information
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NPI Number | 1649760919
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Entity Type | Organization
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Legal Business Name | ROSALIND BULLARD ACUPUNCTURE INC.
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Dates
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Enumeration Date | 05/13/2018
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Last Update Date | 05/13/2018
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Provider Practice Location Address
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Address Line | 2945 ROWENA AVE
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City | LOS ANGELES
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State | CA
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Zip | 90039-2003
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Country | US
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Telephone | 323-522-3822
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Fax |
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Provider Business Mailing Address
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Address Line | 3017 LA PAZ DR
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City | LOS ANGELES
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State | CA
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Zip | 90039-2011
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Country | US
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Telephone | 347-572-5686
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Fax |
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Authorized Official
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Title or Position | OWNER/ACUPUNCTURIST
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Name | ROSALIND D BULLARD
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Credential | L.AC., MSTOM
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Telephone | 323-522-3822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 16585
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License Number State | CA
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