Provider Demographics
NPI:1518734078
Name:KRISTOPHER GOLDSMITH ACUPUNCTURE
Entity Type:Organization
Organization Name:KRISTOPHER GOLDSMITH ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDSMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:310-922-1623
Mailing Address - Street 1:1106 N LA CIENEGA BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069-2493
Mailing Address - Country:US
Mailing Address - Phone:310-922-1623
Mailing Address - Fax:
Practice Address - Street 1:1106 N LA CIENEGA BLVD STE 203
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90069-2493
Practice Address - Country:US
Practice Address - Phone:310-922-1623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center