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Organization
TCR ACUPUNCTURE
Active
Organization
TCR ACUPUNCTURE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY RYAN LAC, QME (OWNER/ACUPUNCTURIST)
(805) 388-6101
Entity
Organization
Contact information
Practice address
2084 VENTURA BLVD, CAMARILLO, CA 93010-7931
(805) 388-6101
Mailing address
2084 VENTURA BLVD, CAMARILLO, CA 93010-7931
(805) 388-6101
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC7965
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1538225966
NPI - TIM RYAN
CA
01
—
1841321866
NPI - JULIE RYAN
CA
01
—
ZZZ03814Z
BLUE SHIELD PROVIDER ID
CA
Enumeration date
01/08/2008
Last updated
01/08/2008
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