Provider Demographics
NPI:1285330928
Name:TARA ACUPUNCTURE & WELLNESS INC
Entity type:Organization
Organization Name:TARA ACUPUNCTURE & WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, CFO, SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:TARA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:DACM, LAC
Authorized Official - Phone:619-289-7757
Mailing Address - Street 1:16516 BERNARDO CENTER DR STE 320
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2552
Mailing Address - Country:US
Mailing Address - Phone:619-289-7757
Mailing Address - Fax:
Practice Address - Street 1:16516 BERNARDO CENTER DR STE 320
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2552
Practice Address - Country:US
Practice Address - Phone:619-289-7757
Practice Address - Fax:619-353-0553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-03
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty