Provider Demographics
NPI:1336656727
Name:NIKI RARIG ND LAC INC
Entity Type:Organization
Organization Name:NIKI RARIG ND LAC INC
Other - Org Name:EAST WEST NATURAL MEDICINE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NIKI
Authorized Official - Middle Name:BROOK
Authorized Official - Last Name:RARIG
Authorized Official - Suffix:
Authorized Official - Credentials:ND, LAC
Authorized Official - Phone:805-543-8958
Mailing Address - Street 1:1415 HIGUERA ST
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-2915
Mailing Address - Country:US
Mailing Address - Phone:805-543-8958
Mailing Address - Fax:805-543-4403
Practice Address - Street 1:1415 HIGUERA ST
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-2915
Practice Address - Country:US
Practice Address - Phone:805-543-8958
Practice Address - Fax:905-543-4403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-07
Last Update Date:2018-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC17662171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1386014306OtherNPI