Provider Demographics
NPI:1427612241
Name:TRINITY ACUPUNCTURE & INTEGRATED MEDCARE, INC
Entity type:Organization
Organization Name:TRINITY ACUPUNCTURE & INTEGRATED MEDCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CLARA
Authorized Official - Middle Name:I
Authorized Official - Last Name:KEY
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:760-870-4181
Mailing Address - Street 1:16785 BEAR VALLEY ROAD, SUITE 4
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92345-1423
Mailing Address - Country:US
Mailing Address - Phone:760-870-4181
Mailing Address - Fax:760-646-8037
Practice Address - Street 1:16785 BEAR VALLEY ROAD, SUITE 4
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-1423
Practice Address - Country:US
Practice Address - Phone:760-870-4181
Practice Address - Fax:760-646-8037
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRINITY ACUPUNCTURE & INTEGRATED ME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-26
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty