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NPI Code Detail

MEDICARE: PAMELA MIURA L.AC.

MEDICARE: PAMELA MIURA L.AC.
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
1171100000XAcupuncturistAC6643CA

General Provider Information

NPI Number : 1205164068
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAMELA MIURA L.AC.
Provider Business Mailing Address
First Line : 4110 EAST BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90066-4610
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5522 SEPULVEDA BLVD
Second Line :
City : SHERMAN OAKS
State : CA
Zip : 91411-3437
Country : US
Telephone Number : 818-988-7988
Fax Number : 818-988-7588
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2009
Last Update Date : 12/04/2009

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Directions to “ PAMELA MIURA L.AC.” Practice Location

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