Provider Demographics
NPI:1982025615
Name:ALCOCER ACUPUNCTURE MEDICAL CLINIC INC
Entity Type:Organization
Organization Name:ALCOCER ACUPUNCTURE MEDICAL CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST
Authorized Official - Prefix:MR
Authorized Official - First Name:XIAOLONG
Authorized Official - Middle Name:
Authorized Official - Last Name:ALCOCER
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:626-377-0699
Mailing Address - Street 1:23887 SUNNYMEAD BLVD
Mailing Address - Street 2:SUITE. C
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-0528
Mailing Address - Country:US
Mailing Address - Phone:626-377-0699
Mailing Address - Fax:
Practice Address - Street 1:23887 SUNNYMEAD BLVD
Practice Address - Street 2:SUITE. C
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-0528
Practice Address - Country:US
Practice Address - Phone:626-377-0699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-24
Last Update Date:2013-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15737171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty