Provider Demographics
NPI:1144751231
Name:PACIFIC INTERNATIONAL ACUPUNCTURE & HEALING, INC
Entity Type:Organization
Organization Name:PACIFIC INTERNATIONAL ACUPUNCTURE & HEALING, INC
Other - Org Name:PACIFIC INTERNATIONAL HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-874-8881
Mailing Address - Street 1:4401 MANCHESTER AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-7904
Mailing Address - Country:US
Mailing Address - Phone:760-452-0766
Mailing Address - Fax:
Practice Address - Street 1:4401 MANCHESTER AVE STE 202
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-7904
Practice Address - Country:US
Practice Address - Phone:760-452-0766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-21
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC3024261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center