Individual provider Active NPI

Ghoncheh Ayazi, LAC, DTCM

  • Acupuncturist
  • San Diego, CA
National Provider Identifier
1336895465
Registry record updated Feb 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
18992 Issued in CA
Practice address
3911 Fifth Ave Ste 208
San Diego, CA 92103-3146
Phone
(858) 333-7688
NPI assigned
Feb 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 18992 CA Primary

Addresses

Primary practice location

3911 Fifth Ave Ste 208
San Diego, CA 92103-3146

Mailing address

1851 31St St
San Diego, CA 92102-1107
Phone (818) 636-2683

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

NPI Registry JSON

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

{
    "created_epoch": "1646006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1336895465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 31ST ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921021107",
            "telephone_number": "818-636-2683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 FIFTH AVE STE 208",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033146",
            "telephone_number": "858-333-7688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYAZI",
        "first_name": "GHONCHEH",
        "credential": "LAC, DTCM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-28",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "18992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 28, 2022; 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.