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Organization
SAN DIEGO ACUPUNCTURE AND NATURAL MEDICINE
Active
Organization
SAN DIEGO ACUPUNCTURE AND NATURAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARCY DIVANTERRA ND, LAC (PRACTITIONER, OWNER)
(619) 887-0610
Entity
Organization
Contact information
Practice address
3636 4TH AVE STE 210, SAN DIEGO, CA 92103-4237
(619) 501-5654
(619) 785-3387
Mailing address
3636 4TH AVE STE 210, SAN DIEGO, CA 92103-4237
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
8921
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ23467P
BLUE SHIELD OF CALIFORNIA
—
01
—
ZZZ55242Y
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
07/28/2010
Last updated
12/27/2017
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