Basic Information
Provider Information
NPI: 1427239235
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KNAUP
FirstName: SARAH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: L.AC.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5677 OBERLIN DR
Address2: SUITE 106
City: SAN DIEGO
State: CA
PostalCode: 921211740
CountryCode: US
TelephoneNumber: 8584578419
FaxNumber: 8584570670
Practice Location
Address1: 5677 OBERLIN DR
Address2: SUITE 106
City: SAN DIEGO
State: CA
PostalCode: 921211740
CountryCode: US
TelephoneNumber: 8584578419
FaxNumber: 8584570670
Other Information
ProviderEnumerationDate: 11/20/2007
LastUpdateDate: 02/26/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
171100000XAC10262CAY Other Service ProvidersAcupuncturist 

No ID Information.


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