Provider Demographics
NPI:1194219592
Name:ACUPUNCTURE & GLOBAL WELLNESS INC
Entity Type:Organization
Organization Name:ACUPUNCTURE & GLOBAL WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ATA
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:MD,LAC
Authorized Official - Phone:818-427-8417
Mailing Address - Street 1:25272 BENTLEY
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-4610
Mailing Address - Country:US
Mailing Address - Phone:818-427-8417
Mailing Address - Fax:
Practice Address - Street 1:25272 BENTLEY
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-4610
Practice Address - Country:US
Practice Address - Phone:818-427-8417
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-19
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC9891171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty