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General NPI Number Information
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NPI Number | 1700153467
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Entity Type | Organization
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Legal Business Name | COSMETIC ACUPUNCTURE CENTER, INC.
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Dates
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Enumeration Date | 11/23/2011
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Last Update Date | 11/23/2011
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Provider Practice Location Address
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Address Line | 12598 CENTRAL AVE STE 107
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City | CHINO
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State | CA
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Zip | 91710-3500
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Country | US
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Telephone | 909-464-8586
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Fax | 626-646-1927
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Provider Business Mailing Address
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Address Line | 12598 CENTRAL AVE STE 107
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City | CHINO
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State | CA
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Zip | 91710-3500
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Country | US
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Telephone | 909-464-8586
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Fax | 626-646-1927
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Authorized Official
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Title or Position | CEO
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Name | MR. JOSE F GARCIA SOTO
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Credential | M.SC ACUPUNCTURE
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Telephone | 909-464-8586
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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 | AC13590
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC14318
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC13538
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License Number State | CA
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