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General NPI Number Information
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NPI Number | 1699287557
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Entity Type | Individual
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Provider Name | KATARINA RYAN L.AC
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Gender | Female
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Dates
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Enumeration Date | 11/01/2017
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Last Update Date | 11/01/2017
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Provider Practice Location Address
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Address Line | 1224 E GREEN ST
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City | PASADENA
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State | CA
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Zip | 91106-3171
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Country | US
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Telephone | 626-755-6260
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Fax |
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Provider Business Mailing Address
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Address Line | 3320 HENRIETTA AVE
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City | GLENDALE
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State | CA
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Zip | 91214-1212
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Country | US
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Telephone | 323-333-2835
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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 | 13068
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License Number State | CA
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