Pain Care Clinic Acupuncture

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

15336 Issued in CA

Legal business name

PAIN CARE CLINIC ACUPUNCTURE

Practice address

31740 Railroad Canyon Rd
Suite 3
Canyon Lake, CA 92587-9490

Phone

(909) 997-9966

Fax

(951) 244-5757

NPI assigned

Oct 15, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Tina Yan Li, O.M.D.

Title

President

Phone

(909) 997-9966

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1476489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476489600000",
    "number": "1154872083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31740 RAILROAD CANYON RD",
            "address_2": "SUITE 3",
            "city": "CANYON LAKE",
            "state": "CA",
            "postal_code": "925879490",
            "telephone_number": "909-997-9966",
            "fax_number": "951-244-5757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31740 RAILROAD CANYON RD",
            "address_2": "SUITE 3",
            "city": "CANYON LAKE",
            "state": "CA",
            "postal_code": "925879490",
            "telephone_number": "909-997-9966",
            "fax_number": "951-244-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN CARE CLINIC ACUPUNCTURE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-15",
        "last_updated": "2016-10-15",
        "status": "A",
        "authorized_official_last_name": "LI",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "YAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-997-9966",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.M.D."
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "15336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Acupuncturist in Canyon Lake, CA
• Providers in Canyon Lake, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2016; 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.