Most Relevant Information
Provider Data
| NPI Number: | 1003371121 |
| Provider Name: | KENJI MATSUSAKA L.AC. |
| Entity Type: | Individual |
| Taxonomy Code: | 171100000X |
| Specialty: | Acupuncturist |
| License Number: | 17442 |
Most Important Dates
| Enumeration Date: | 02/02/2019 |
| Last Updated: | 02/02/2019 |
Provider Practice Location
4847 NEWPORT AVE
SAN DIEGO
CA
921073110
Practice Location Phone/Fax
| Phone: | 6195509747 |
| Fax: |
Provider Mailing Location
1307 24TH ST
SAN DIEGO
CA
921022013
Provider Mailing Phone/Fax
| Phone: | 7817276341 |
| Fax: |