Provider Demographics
NPI:1295014264
Name:LOS ANGELES MOBILE ACUPUNCTURE
Entity Type:Organization
Organization Name:LOS ANGELES MOBILE ACUPUNCTURE
Other - Org Name:ALMA MYERS, LAC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC DIRECTOR/ACUPUNCTURIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ALMA
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:886-629-8089
Mailing Address - Street 1:19100 VENTURA BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3239
Mailing Address - Country:US
Mailing Address - Phone:866-629-8089
Mailing Address - Fax:310-997-2665
Practice Address - Street 1:19100 VENTURA BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3239
Practice Address - Country:US
Practice Address - Phone:866-629-8089
Practice Address - Fax:310-997-2665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-09
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13391171100000X
CA13863171100000X
CA13647171100000X
CA13546171100000X
CA14111171100000X
CA14416171100000X
CA13317171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty