Provider Demographics
NPI:1205060126
Name:ACUPUNCTURE HEALTHCARE INC.
Entity type:Organization
Organization Name:ACUPUNCTURE HEALTHCARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:DR
Authorized Official - First Name:RON
Authorized Official - Middle Name:CLYDE
Authorized Official - Last Name:LORD
Authorized Official - Suffix:JR
Authorized Official - Credentials:LAC OMD
Authorized Official - Phone:858-458-0625
Mailing Address - Street 1:5445 OBERLIN DR
Mailing Address - Street 2:SUITE # 101
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-1704
Mailing Address - Country:US
Mailing Address - Phone:858-458-0625
Mailing Address - Fax:
Practice Address - Street 1:5445 OBERLIN DR
Practice Address - Street 2:SUITE # 101
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1704
Practice Address - Country:US
Practice Address - Phone:858-458-0625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-06
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALAC9362171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty