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General NPI Number Information
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NPI Number | 1881170397
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Entity Type | Organization
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Legal Business Name | EAST WEST ACUPUNCTURE CENTER
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Dates
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Enumeration Date | 07/17/2018
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Last Update Date | 07/17/2018
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Provider Practice Location Address
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Address Line | 151 N SUNRISE AVE STE 819
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City | ROSEVILLE
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State | CA
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Zip | 95661-2928
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Country | US
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Telephone | 916-786-8100
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Fax | 916-786-8105
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Provider Business Mailing Address
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Address Line | 151 N SUNRISE AVE STE 819
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City | ROSEVILLE
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State | CA
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Zip | 95661-2928
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Country | US
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Telephone | 191-678-6810
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Fax |
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Authorized Official
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Title or Position | LICENSED ACUPUNCTURIST
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Name | MS. ROXANNE ALEE
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Credential | L.AC.
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Telephone | 916-786-8100
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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 | 7403
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License Number State | CA
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