# FOSTER RYAN, LAC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mar Vista Center for Acupuncture
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902277791
- **Authorized official:** MR. MAURY FOSTER RYAN LAC (ACUPUNCTURIST)
- **Authorized official phone:** (310) 390-7155

## Contact information

- **Practice address:** 12114 VENICE BLVD, LOS ANGELES, CA 90066-3812
- **Practice address phone:** (310) 390-7155
- **Practice address fax:** (310) 390-7836
- **Mailing address:** 12114 VENICE BLVD, LOS ANGELES, CA 90066-3812
- **Mailing address phone:** (310) 390-7155
- **Mailing address fax:** (310) 390-7836

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | AC7559 | CA | Yes |

## Other

- **Enumeration date:** 10/19/2015
- **Last updated:** 10/19/2015