| |
5567 Reseda Blvd, # 101, Tarzana, CA 91356-2674 | |
(213) 387-4710 | |
(213) 387-4811 |
Full Name | |
---|---|
Type | Facility |
Speciality | Acupuncturist |
Location | 5567 Reseda Blvd, Tarzana, California |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1235370768 | NPI | - | NPPES |
1972694453 | Other | CA | NPI |
1740274976 | Other | CA | INDIVITUAL NPI |
1235370768 | Other | CA | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | DC33075 (California) | Secondary |
111N00000X | Chiropractor | DC15287 (California) | Secondary |
171100000X | Acupuncturist | AC2332 (California) | Primary |
Mailing Address | Practice Location Address |
---|---|
5567 Reseda Blvd, # 101, Tarzana, CA 91356-2674 Ph: (213) 387-4710 | 5567 Reseda Blvd, # 101, Tarzana, CA 91356-2674 Ph: (213) 387-4710 |