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General NPI Number Information
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NPI Number | 1831635135
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Entity Type | Organization
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Legal Business Name | CHONG ACUPUNCTURE AND INTEGRATIVE MEDICINE
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Dates
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Enumeration Date | 01/10/2017
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Last Update Date | 01/10/2017
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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 | 760-307-8801
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Fax |
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Provider Business Mailing Address
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Address Line | 7770 REGENTS RD S.113-310
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City | SAN DIEGO
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State | CA
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Zip | 92122-2421
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Country | US
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Telephone | 760-642-2100
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SIATNEE CHONG
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Credential | LAC
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Telephone | 619-723-5566
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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 | 16983
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License Number State | CA
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