=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710838768
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TICZON ACUPUNCTURE CLINICAL INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/05/2026
-----------------------------------------------------
Last Update Date | 02/05/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 550 E 8TH ST STE 14B
-----------------------------------------------------
City | NATIONAL CITY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91950-2354
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-855-8273
-----------------------------------------------------
Fax | 619-773-7355
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 550 E 8TH ST STE 14B
-----------------------------------------------------
City | NATIONAL CITY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91950-2354
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-855-8273
-----------------------------------------------------
Fax | 619-773-7355
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LICENSED ACUPUNCTURIST
-----------------------------------------------------
Name | LOURDES R ORTEGA-TICZON
-----------------------------------------------------
Credential | LAC
-----------------------------------------------------
Telephone | 619-855-8273
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------