Provider Demographics
NPI:1902213531
Name:ARC HEALTH CENTER
Entity Type:Organization
Organization Name:ARC HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:ANTONY
Authorized Official - Middle Name:Y
Authorized Official - Last Name:LIM
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:858-692-4212
Mailing Address - Street 1:2636 WORDEN ST
Mailing Address - Street 2:#131
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-5877
Mailing Address - Country:US
Mailing Address - Phone:858-692-4212
Mailing Address - Fax:
Practice Address - Street 1:3435 CAMINO DEL RIO S
Practice Address - Street 2:#307
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3902
Practice Address - Country:US
Practice Address - Phone:619-591-8452
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-15
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 8793261QM2500X
CAAC8793261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty