Individual
CAROL RIDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
6046 CORNERSTONE CT W, STE. 104, SAN DIEGO, CA 92121-4758
(858) 453-2048
Mailing address
6046 CORNERSTONE CT W, STE. 104, SAN DIEGO, CA 92121-4758
(858) 453-2048
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC5937
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AC5937
LICENSE NUMBER
CA
Enumeration date
12/11/2006
Last updated
07/08/2007
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