Crystal Rose Tank, DAOM, LMP
Acupuncturist in San Diego, CA. Individual provider (NPI-1).
NPI number1982148672
StatusActive
Last updated in NPPESMar 26, 2025
Details
- NPI
- 1982148672
- Entity type
- Individual (NPI-1)
- Name
- Crystal Rose Tank
- Credential
- DAOM, LMP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Dec 14, 2016
- Certification date
- Mar 26, 2025
- Last updated
- Mar 26, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171100000X | Acupuncturist | AC20186 | CA | Yes |
| 171100000X | Acupuncturist | AC60723656 | WA | |
| 172M00000X | Mechanotherapist | MA60448826 | WA | |
| 172M00000X | Mechanotherapist | 3134 | CA |
Practice location
3239 Adams AveSan Diego, CA 92116-1645
Phone 619-546-4806
Mailing address
3239 Adams AveSan Diego, CA 92116-1645
Phone 619-546-4806
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