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General NPI Number Information
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NPI Number | 1841717634
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Entity Type | Individual
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Provider Name | KRISTEL HART L.AC.
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Gender | Female
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Dates
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Enumeration Date | 08/23/2017
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Last Update Date | 08/23/2017
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Provider Practice Location Address
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Address Line | 12304 SANTA MONICA BLVD STE 120
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City | LOS ANGELES
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State | CA
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Zip | 90025-2586
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Country | US
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Telephone | 310-826-5288
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Fax |
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Provider Business Mailing Address
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Address Line | 12340 ROCHESTER AVE APT 120
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City | LOS ANGELES
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State | CA
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Zip | 90025-2021
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Country | US
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Telephone | 310-869-0712
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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 | 15823
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License Number State | CA
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