Provider Demographics
NPI:1790452357
Name:ISLAND ACUPUNCTURE INC
Entity Type:Organization
Organization Name:ISLAND ACUPUNCTURE INC
Other - Org Name:GILA PELED, GILA CAPLAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GILA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:DAOM
Authorized Official - Phone:619-435-2522
Mailing Address - Street 1:1222 1ST ST STE 6
Mailing Address - Street 2:
Mailing Address - City:CORONADO
Mailing Address - State:CA
Mailing Address - Zip Code:92118-1491
Mailing Address - Country:US
Mailing Address - Phone:619-435-2522
Mailing Address - Fax:619-435-2511
Practice Address - Street 1:1222 1ST ST STE 6
Practice Address - Street 2:
Practice Address - City:CORONADO
Practice Address - State:CA
Practice Address - Zip Code:92118-1491
Practice Address - Country:US
Practice Address - Phone:619-435-2522
Practice Address - Fax:619-435-2511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1942349667Medicaid