Provider Demographics
NPI:1811463631
Name:SMART HEALTH ACUPUNCTURE, PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:SMART HEALTH ACUPUNCTURE, PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LALA
Authorized Official - Suffix:
Authorized Official - Credentials:DACM, LAC
Authorized Official - Phone:619-890-7519
Mailing Address - Street 1:PO BOX 711794
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92072-1794
Mailing Address - Country:US
Mailing Address - Phone:619-890-7519
Mailing Address - Fax:
Practice Address - Street 1:7373 UNIVERSITY AVE STE 211
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-0524
Practice Address - Country:US
Practice Address - Phone:619-881-0428
Practice Address - Fax:619-436-1032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-18
Last Update Date:2019-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty