Provider Demographics
NPI:1346762119
Name:CHRISTINA BIRD ACUPUNCTURE, PC
Entity Type:Organization
Organization Name:CHRISTINA BIRD ACUPUNCTURE, PC
Other - Org Name:CHRISTINA BIRD ACUPUNCTURE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:LYNN BIRD
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:619-630-5228
Mailing Address - Street 1:1050 ISLAND AVE UNIT 318
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-7261
Mailing Address - Country:US
Mailing Address - Phone:619-630-5228
Mailing Address - Fax:
Practice Address - Street 1:305 LAUREL ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-1630
Practice Address - Country:US
Practice Address - Phone:619-630-5228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-12
Last Update Date:2017-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC15093261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service