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General NPI Number Information
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NPI Number | 1871214197
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Entity Type | Organization
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Legal Business Name | NATHALIE VITALITY ACUPUNCTURE
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Dates
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Enumeration Date | 09/06/2022
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Last Update Date | 09/06/2022
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Provider Practice Location Address
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Address Line | 2001 S BARRINGTON AVE STE 220
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City | LOS ANGELES
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State | CA
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Zip | 90025-5385
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Country | US
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Telephone | 310-612-5464
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Fax |
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Provider Business Mailing Address
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Address Line | 302 ASHLAND AVE UNIT 201
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City | SANTA MONICA
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State | CA
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Zip | 90405-5492
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Country | US
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Telephone | 310-612-5464
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | NATHALIE SHAPIRO
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Credential | LAC
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Telephone | 310-612-5464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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