Provider Demographics
NPI:1982100590
Name:SEVA, LLC
Entity type:Organization
Organization Name:SEVA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:MILI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:619-839-9018
Mailing Address - Street 1:11624 CANDY ROSE WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-3852
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:619-331-2983
Practice Address - Street 1:1281 UNIVERSITY AVE STE E
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-7305
Practice Address - Country:US
Practice Address - Phone:619-839-9018
Practice Address - Fax:619-331-2983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16551171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty