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General NPI Number Information
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NPI Number | 1912246448
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Entity Type | Organization
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Legal Business Name | SOURCEPOINT ACUPUNCTURE INC
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Dates
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Enumeration Date | 02/04/2013
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Last Update Date | 02/04/2013
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Provider Practice Location Address
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Address Line | 7339 EL CAJON BLVD SUITE M
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City | LA MESA
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State | CA
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Zip | 91942-7435
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Country | US
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Telephone | 619-466-6150
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Fax | 619-342-7767
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Provider Business Mailing Address
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Address Line | 4827 COLLWOOD BLVD UNIT B
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City | SAN DIEGO
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State | CA
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Zip | 92115-2173
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Country | US
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Telephone | 619-892-1611
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Fax | 619-342-7767
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. DAVID MICHAEL HAHN
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Credential | L.AC.
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Telephone | 619-892-1611
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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 12273
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License Number State | CA
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