MEDICARE: MR. JARED JOSEPH LIEN L.AC. RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist		CA

General Provider Information

NPI Number	:	1134547649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JARED JOSEPH LIEN L.AC. RN

Provider Business Mailing Address
First Line	:	1235 DIAMOND ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92109-2645
Country	:	US
Telephone Number	:	913-707-2052
Fax Number	:

Provider Business Practice Location Address
First Line	:	1235 DIAMOND ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92109-2645
Country	:	US
Telephone Number	:	913-707-2052
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2014
Last Update Date	:	04/01/2014

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