NPIMap

Organization Active NPI

Sustain Community Acupuncture

  • Acupuncturist
  • San Diego, CA
National Provider Identifier
1104124577
Registry record updated Mar 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC 12894 Issued in CA
Legal business name
SUSTAIN COMMUNITY ACUPUNCTURE
Practice address
2537 University Ave
San Diego, CA 92104-2807
Phone
(619) 358-9508
Fax
(619) 727-4543
NPI assigned
Mar 8, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Dave W McKinnon, LAC
Title
Ceo
Phone
(619) 358-9508

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X AC 12894 CA Primary

Addresses

Primary practice location

2537 University Ave
San Diego, CA 92104-2807

Mailing address

2537 University Ave
San Diego, CA 92104-2807
Phone (619) 358-9508

Other names 1

  • Sustain Community Acupuncture Doing business as

National Provider Directory

National Provider Directory

Locations

2537 University Ave
San Diego, CA 92104
Phone (619) 358-9508

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1299542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299542400000",
    "number": "1104124577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2537 UNIVERSITY AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921042807",
            "telephone_number": "619-358-9508",
            "fax_number": "619-727-4543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2537 UNIVERSITY AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921042807",
            "telephone_number": "619-358-9508",
            "fax_number": "619-727-4543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSTAIN COMMUNITY ACUPUNCTURE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-08",
        "last_updated": "2011-03-08",
        "status": "A",
        "authorized_official_last_name": "MCKINNON",
        "authorized_official_first_name": "DAVE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "619-358-9508",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LAC"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC 12894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sustain Community Acupuncture",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.