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General NPI Number Information
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NPI Number | 1720528128
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Entity Type | Organization
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Legal Business Name | DAYDREAM ACUPUNCTURE, INC.
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Dates
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Enumeration Date | 03/03/2017
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Last Update Date | 03/03/2017
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Provider Practice Location Address
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Address Line | 155 W HOSPITALITY LN SUITE 175
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City | SAN BERNARDINO
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State | CA
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Zip | 92408-3305
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Country | US
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Telephone | 818-550-7860
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Fax | 818-550-7861
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Provider Business Mailing Address
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Address Line | 600 W BROADWAY SUITE 135
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City | GLENDALE
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State | CA
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Zip | 91204-1022
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Country | US
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Telephone | 818-550-7860
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Fax | 818-550-7861
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Authorized Official
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Title or Position | OFFICER
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Name | GAGIK ISAHAKIAN
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Credential | L.AC.
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Telephone | 818-550-7860
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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 | 6852
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License Number State | CA
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