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General NPI Number Information
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NPI Number | 1922466440
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Entity Type | Organization
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Legal Business Name | POSTOLOVA ACUPUNCTURE GROUP, INC.
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Dates
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Enumeration Date | 01/29/2016
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Last Update Date | 01/29/2016
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Provider Practice Location Address
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Address Line | 1990 S BUNDY DR SUITE 790
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City | LOS ANGELES
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State | CA
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Zip | 90025-5240
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Country | US
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Telephone | 310-444-6212
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Fax | 888-650-9839
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Provider Business Mailing Address
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Address Line | 1990 S BUNDY DR SUITE 790
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City | LOS ANGELES
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State | CA
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Zip | 90025-5240
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Country | US
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Telephone | 310-444-6212
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Fax | 888-650-9839
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Authorized Official
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Title or Position | OWNER
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Name | MS. LUCY POSTOLOV
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Credential | L.AC.
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Telephone | 310-444-6212
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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 | AC5202
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License Number State | CA
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