Provider Demographics
NPI:1770510745
Name:TCMA ACUPUNCTURE
Entity Type:Organization
Organization Name:TCMA ACUPUNCTURE
Other - Org Name:NEWPORT WELLNESS GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHOHRE
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHVAR
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, DOM
Authorized Official - Phone:949-514-7675
Mailing Address - Street 1:180 NEWPORT CENTER DR STE 145
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-6983
Mailing Address - Country:US
Mailing Address - Phone:949-760-2701
Mailing Address - Fax:949-760-2722
Practice Address - Street 1:180 NEWPORT CENTER DR STE 145
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-6983
Practice Address - Country:US
Practice Address - Phone:949-760-2701
Practice Address - Fax:949-760-2722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-27
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty