1952768723 NPI number — THE TOTAL HEALTH CENTER ACUPUNCTURE AND NATURAL MEDICINE

Table of content: (NPI 1952768723)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952768723 NPI number — THE TOTAL HEALTH CENTER ACUPUNCTURE AND NATURAL MEDICINE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE TOTAL HEALTH CENTER ACUPUNCTURE AND NATURAL MEDICINE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952768723
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/25/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10061 RIVERSIDE DR
Provider Second Line Business Mailing Address:
811
Provider Business Mailing Address City Name:
TOLUCA LAKE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91602-2560
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-509-9233
Provider Business Mailing Address Fax Number:
818-301-0333

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4444 LANKERSHIM BLVD
Provider Second Line Business Practice Location Address:
104
Provider Business Practice Location Address City Name:
TOLUCA LAKE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91602-2346
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-509-9233
Provider Business Practice Location Address Fax Number:
818-301-0333
Provider Enumeration Date:
01/25/2016

Additional Information

Authorized Official

Authorized Official Last Name:
BRADSHAW
Authorized Official First Name:
NICOLE
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
818-509-9233

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  AC8406 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com