Provider Demographics
NPI:1154805513
Name:INDIGO AND EASE ACUPUNCTURE AND INTEGRATIVE HEALTH INCORPORATED
Entity type:Organization
Organization Name:INDIGO AND EASE ACUPUNCTURE AND INTEGRATIVE HEALTH INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:YANNINA
Authorized Official - Middle Name:
Authorized Official - Last Name:TORTI
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:619-592-5268
Mailing Address - Street 1:875 G ST UNIT 507
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-6462
Mailing Address - Country:US
Mailing Address - Phone:619-592-5268
Mailing Address - Fax:
Practice Address - Street 1:7730 HERSCHEL AVE STE D
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-4432
Practice Address - Country:US
Practice Address - Phone:619-796-1323
Practice Address - Fax:619-228-9150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-21
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty