Provider Demographics
NPI:1841691672
Name:ACULIBRIUM
Entity type:Organization
Organization Name:ACULIBRIUM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:SNYDER
Authorized Official - Last Name:BLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DAOM, LAC, MSTOM
Authorized Official - Phone:424-442-0635
Mailing Address - Street 1:2313 WESTWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-2109
Mailing Address - Country:US
Mailing Address - Phone:424-442-0635
Mailing Address - Fax:310-446-0403
Practice Address - Street 1:2313 WESTWOOD BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-2109
Practice Address - Country:US
Practice Address - Phone:424-442-0635
Practice Address - Fax:310-446-0403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-11
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14843171100000X
CA14649171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1891107785OtherNPI
CA1346508181OtherNPI