Individual provider Active NPI

Ron Clyde Lord Jr., CA.LAC 9362

  • Acupuncturist
  • San Diego, CA
National Provider Identifier
1760723290
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
9362 Issued in CA
Practice address
12396 World Trade Dr Ste 117
San Diego, CA 92128-3788
Phone
(858) 458-0625
Fax
(858) 750-2174
NPI assigned
Mar 7, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 9362 CA Primary

Addresses

Primary practice location

12396 World Trade Dr Ste 117
San Diego, CA 92128-3788

Mailing address

12396 World Trade Dr Ste 117
San Diego, CA 92128-3788
Phone (858) 458-0625

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

LicenseStateTypeSpecialty
9362CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Acupuncture Healthcare Inc. Acupuncturist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1362614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1760723290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12396 WORLD TRADE DR STE 117",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283788",
            "telephone_number": "858-458-0625",
            "fax_number": "858-750-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12396 WORLD TRADE DR STE 117",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283788",
            "telephone_number": "858-458-0625",
            "fax_number": "858-750-2174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORD",
        "first_name": "RON",
        "middle_name": "CLYDE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "CA.LAC 9362",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-07",
        "last_updated": "2023-10-03",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "9362",
            "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 Oct 3, 2023; 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.