Provider Demographics
NPI:1225560402
Name:ACU-FIT
Entity Type:Organization
Organization Name:ACU-FIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLO
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:760-587-3662
Mailing Address - Street 1:582 SWEET PEA PL
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-7713
Mailing Address - Country:US
Mailing Address - Phone:760-587-3662
Mailing Address - Fax:858-509-3993
Practice Address - Street 1:582 SWEET PEA PL
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-7713
Practice Address - Country:US
Practice Address - Phone:760-587-3662
Practice Address - Fax:858-509-3993
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACU-FIT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC13480171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty