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General NPI Number Information
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NPI Number | 1760635726
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Entity Type | Individual
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Provider Name | CHRISTINA ANDRADE LEIGH MAOM, LAC, DIPL.AC.
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Gender | Female
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Dates
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Enumeration Date | 11/03/2008
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Last Update Date | 11/17/2014
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Provider Practice Location Address
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Address Line | 1054 2ND ST
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City | ENCINITAS
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State | CA
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Zip | 92024-5009
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Country | US
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Telephone | 760-383-1460
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Fax |
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Provider Business Mailing Address
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Address Line | 539 WILLOWSPRING DR S
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City | ENCINITAS
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State | CA
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Zip | 92024-4104
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Country | US
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Telephone | 858-245-1817
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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 | 12791
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License Number State | CA
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