Provider Demographics
NPI:1154677169
Name:VITALITY ACUPUNCTURE
Entity Type:Organization
Organization Name:VITALITY ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED ACUPUNCTURIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:ROHRBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:619-818-2358
Mailing Address - Street 1:3023 BUNKER HILL ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-5706
Mailing Address - Country:US
Mailing Address - Phone:619-818-2358
Mailing Address - Fax:858-750-3500
Practice Address - Street 1:3023 BUNKER HILL ST
Practice Address - Street 2:SUITE 201
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-5706
Practice Address - Country:US
Practice Address - Phone:619-818-2358
Practice Address - Fax:858-750-3500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-27
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 10643171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty