Active NPI
Lorenzo Tien Phan, L.AC
- Acupuncturist
- Ormond Beach, FL
National Provider Identifier
1174697643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC00803
- Practice address
- 725 W Granada Blvd Unit 17
Ormond Beach, FL 32174-5107 - Phone
- (386) 255-6953
- NPI assigned
- Nov 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC00803 | TX | Primary |
Addresses
Primary practice location
725 W Granada Blvd Unit 17
Ormond Beach, FL 32174-5107
Mailing address
946 15TH St Apt 202
Holly Hill, FL 32117-2076
Phone (386) 212-9131
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AC00803 | TX | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174697643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "946 15TH ST APT 202",
"city": "HOLLY HILL",
"state": "FL",
"postal_code": "321172076",
"telephone_number": "386-212-9131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 W GRANADA BLVD UNIT 17",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321745107",
"telephone_number": "386-255-6953"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "LORENZO",
"middle_name": "TIEN",
"credential": "L.AC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "TX",
"license": "AC00803",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ormond Beach, FL
- Savanna M. Peterson, DMD
- Marcia Kay Peterzell, APRN
- Lawrence Richard Petker, D.C.
- Vito Aniello Petrozzino, M.D.
- Tamara Fields Pettit, MS, LMFT
- Pharaohs Trading L.L.C.
- Terri Phoenix, M.ED., LPC, NCC
- Phpts of Ormond Beach, LLC
- Physicians Ambulatory Surgery Center Inc
- Charles Lawrence Piazza Jr., DPT, ATC, MTC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.