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General NPI Number Information
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NPI Number | 1891122800
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Entity Type | Organization
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Legal Business Name | EAST WEST NATURAL MEDICINE CENTER, LLC
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Dates
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Enumeration Date | 10/04/2013
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Last Update Date | 10/27/2016
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Provider Practice Location Address
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Address Line | 1415 HIGUERA ST
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-2915
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Country | US
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Telephone | 805-543-8958
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Fax | 805-543-4403
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Provider Business Mailing Address
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Address Line | 1415 HIGUERA ST
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-2915
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Country | US
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Telephone | 805-543-8958
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Fax | 805-543-4403
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Authorized Official
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Title or Position | OWNER
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Name | DR. JULIANNA ENGLUND
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Credential | N.D., L.AC
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Telephone | 805-543-8958
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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 | AC 3174
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | ND-473
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC 14714
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License Number State | CA
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