Individual
MS. DIANNE GRACE MALLIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
2330 MAIN ST STE D, RAMONA, CA 92065-2539
(858) 208-8250
Mailing address
17218 BOCA RATON LN, POWAY, CA 92064-1304
(802) 734-3838
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
091.0000161
VT
171100000X
Acupuncturist
Primary
AC3885
CA
Other
Enumeration date
03/06/2014
Last updated
05/26/2020
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