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General NPI Number Information
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NPI Number | 1760970255
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Entity Type | Organization
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Legal Business Name | ACUPUNCTURE&CHIROPRACTIC CENTER OF ESCONDIDO PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 04/30/2018
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Last Update Date | 04/30/2018
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Provider Practice Location Address
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Address Line | 1733 S ESCONDIDO BLVD
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City | ESCONDIDO
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State | CA
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Zip | 92025-6519
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Country | US
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Telephone | 760-233-5886
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Fax | 760-233-1473
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Provider Business Mailing Address
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Address Line | 3369 AVENIDA MAGORIA
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City | ESCONDIDO
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State | CA
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Zip | 92029-7435
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Country | US
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Telephone | 760-738-8828
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST/ OWNER
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Name | FARAHNAZ AKHAVAN
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Credential | L.AC
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Telephone | 760-233-5886
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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 | AC9396
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License Number State | CA
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