Individual
BETH THEODORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
1020 MISSION ST, SOUTH PASADENA, CA 91030-3171
(310) 804-2093
Mailing address
107 S HOLLISTON AVE, #205, PASADENA, CA 91106-2639
(310) 804-2093
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC7611
CA
Other
Enumeration date
05/31/2007
Last updated
07/08/2007
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