Provider Demographics
NPI:1750574281
Name:FAMILY MEDICAL ACUPUNCTURE GROUP
Entity type:Organization
Organization Name:FAMILY MEDICAL ACUPUNCTURE GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:SPERBER
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, DAOM
Authorized Official - Phone:619-760-7100
Mailing Address - Street 1:2515 CAMINO DEL RIO S
Mailing Address - Street 2:SUITE #220
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3792
Mailing Address - Country:US
Mailing Address - Phone:619-760-7100
Mailing Address - Fax:619-393-0438
Practice Address - Street 1:2515 CAMINO DEL RIO S
Practice Address - Street 2:SUITE #220
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3792
Practice Address - Country:US
Practice Address - Phone:619-760-7100
Practice Address - Fax:619-393-0438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC9297171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty