Individual
ELVIRA VASILCHENKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10951 SORRENTO VALLEY RD STE 1D, SAN DIEGO, CA 92121-1613
(619) 598-5488
Mailing address
161 PALM AVE, IMPERIAL BEACH, CA 91932-1048
(619) 354-0455
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
CA18586
CA
405300000X
Prevention Professional
78334
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18586
—
CA
01
—
CA18586
LICENSE
CA
Enumeration date
09/03/2020
Last updated
09/03/2020
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