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General NPI Number Information
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NPI Number | 1801112040
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Entity Type | Organization
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Legal Business Name | L.A. WELLNESS AND ACUPUNCTURE CLINIC, INC.
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Dates
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Enumeration Date | 04/13/2010
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Last Update Date | 03/23/2017
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Provider Practice Location Address
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Address Line | 116 W GRAND AVE
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City | EL SEGUNDO
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State | CA
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Zip | 90245-3737
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Country | US
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Telephone | 310-335-0073
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Fax |
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Provider Business Mailing Address
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Address Line | 116 W GRAND AVE
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City | EL SEGUNDO
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State | CA
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Zip | 90245-3737
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Country | US
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Telephone | 310-335-0073
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Fax | 310-335-0073
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOSEPH V CURCIO
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Credential | L. AC.
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Telephone | 310-335-0073
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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 | AC8689
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License Number State |
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