Provider Demographics
NPI:1558499400
Name:PACIFIC ACUPUNCTURE CENTER
Entity Type:Organization
Organization Name:PACIFIC ACUPUNCTURE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ZHANG
Authorized Official - Middle Name:
Authorized Official - Last Name:XIE
Authorized Official - Suffix:
Authorized Official - Credentials:ACUPUNCTURIST
Authorized Official - Phone:949-489-1911
Mailing Address - Street 1:34255 PACIFIC COAST HWY STE 114
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-3809
Mailing Address - Country:US
Mailing Address - Phone:949-489-1911
Mailing Address - Fax:949-489-0776
Practice Address - Street 1:34255 PACIFIC COAST HWY STE 114
Practice Address - Street 2:
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629-3809
Practice Address - Country:US
Practice Address - Phone:949-489-1911
Practice Address - Fax:949-489-0776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC4347171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherACUPUNCTURE