Provider Demographics
NPI:1215825419
Name:PASKOFF, REGINA (DACCHM, MSTOM, LAC)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:PASKOFF
Suffix:
Gender:X
Credentials:DACCHM, MSTOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4315 MENTONE ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92107-1119
Mailing Address - Country:US
Mailing Address - Phone:347-804-2602
Mailing Address - Fax:
Practice Address - Street 1:2970 FIFTH AVE STE 320
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-5995
Practice Address - Country:US
Practice Address - Phone:858-333-7688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-25
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20244171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist