Provider Demographics
NPI:1609621341
Name:BLUE LOTUS ACUPUNCTURE INC
Entity Type:Organization
Organization Name:BLUE LOTUS ACUPUNCTURE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NOBRIGA
Authorized Official - Suffix:
Authorized Official - Credentials:DAOM, LAC
Authorized Official - Phone:310-625-8632
Mailing Address - Street 1:74133 EL PASEO STE 9
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-4122
Mailing Address - Country:US
Mailing Address - Phone:442-334-7000
Mailing Address - Fax:
Practice Address - Street 1:74133 EL PASEO STE 9
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-4122
Practice Address - Country:US
Practice Address - Phone:442-334-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty