Provider Demographics
NPI:1932208089
Name:TOM, CELIA MARIA (LICENSED ACUPUNCTURI)
Entity Type:Individual
Prefix:DR
First Name:CELIA
Middle Name:MARIA
Last Name:TOM
Suffix:
Gender:F
Credentials:LICENSED ACUPUNCTURI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 GRAND AVE.
Mailing Address - Street 2:SUITE 1-E
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-4578
Mailing Address - Country:US
Mailing Address - Phone:858-270-5454
Mailing Address - Fax:858-270-5509
Practice Address - Street 1:1919 GRAND AVE.
Practice Address - Street 2:SUITE 1-E
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-4578
Practice Address - Country:US
Practice Address - Phone:858-270-5454
Practice Address - Fax:858-270-5509
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC1577171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist