Provider Demographics
NPI:1063265635
Name:PAIN STRESS ANXIETY ACUPUNCTURE PROFESSIONAL CORP
Entity type:Organization
Organization Name:PAIN STRESS ANXIETY ACUPUNCTURE PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:SANDIFER
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:818-426-1310
Mailing Address - Street 1:18351 BEACH BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-1346
Mailing Address - Country:US
Mailing Address - Phone:714-913-3310
Mailing Address - Fax:
Practice Address - Street 1:18351 BEACH BLVD STE B
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-1346
Practice Address - Country:US
Practice Address - Phone:714-913-3310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty