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NPI Code Detail

MEDICARE: MEDICINE OF THE PEACE CORP.

MEDICARE: MEDICINE OF THE PEACE CORP.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171100000XAcupuncturist

General Provider Information

NPI Number : 1346004611
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDICINE OF THE PEACE CORP.
Provider Business Mailing Address
First Line : 4443 30TH ST STE 205
Second Line :
City : SAN DIEGO
State : CA
Zip : 92116-4291
Country : US
Telephone Number : 619-324-9079
Fax Number :
Provider Business Practice Location Address
First Line : 4443 30TH ST STE 205
Second Line :
City : SAN DIEGO
State : CA
Zip : 92116-4291
Country : US
Telephone Number : 619-324-9079
Fax Number :
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER, CEO
Name : DR. TASHA INGRID MINTZER
Credential : DACM L.AC.
Telephone Number : 619-324-9079
Provider Enumeration Date : 02/07/2024
Last Update Date : 02/07/2024

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Directions to “MEDICINE OF THE PEACE CORP. ” Practice Location

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