Provider Demographics
NPI:1316418254
Name:ARROWHEAD ACUPUNCTURE
Entity type:Organization
Organization Name:ARROWHEAD ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:FLACH
Authorized Official - Suffix:JR
Authorized Official - Credentials:LAC
Authorized Official - Phone:858-761-7432
Mailing Address - Street 1:PO BOX 3507
Mailing Address - Street 2:
Mailing Address - City:LAKE ARROWHEAD
Mailing Address - State:CA
Mailing Address - Zip Code:92352-3507
Mailing Address - Country:US
Mailing Address - Phone:909-485-1616
Mailing Address - Fax:
Practice Address - Street 1:29099 HOSPITAL RD
Practice Address - Street 2:SUITE 112 B
Practice Address - City:LAKE ARROWHEAD
Practice Address - State:CA
Practice Address - Zip Code:92352
Practice Address - Country:US
Practice Address - Phone:909-485-1616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service