Provider Demographics
NPI:1750995502
Name:BEAR, TRISHA (DACM, LAC)
Entity type:Individual
Prefix:DR
First Name:TRISHA
Middle Name:
Last Name:BEAR
Suffix:
Gender:F
Credentials:DACM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7964 ARJONS DR STE D
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-4392
Mailing Address - Country:US
Mailing Address - Phone:858-621-3332
Mailing Address - Fax:
Practice Address - Street 1:7964 ARJONS DR STE D
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-4392
Practice Address - Country:US
Practice Address - Phone:858-621-3332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA188122083S0010X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No2083S0010XAllopathic & Osteopathic PhysiciansPreventive MedicineSports Medicine