MEDICARE: DR. MICHAEL L. FOX LAC, PHD

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	11299	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CA0112990	OTHER	CA	BLUE SHIELD

General Provider Information

NPI Number	:	1205925385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL L. FOX LAC, PHD

Provider Business Mailing Address
First Line	:	1727 N VERMONT AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-4343
Country	:	US
Telephone Number	:	323-662-6560
Fax Number	:

Provider Business Practice Location Address
First Line	:	1727 N VERMONT AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-4343
Country	:	US
Telephone Number	:	323-662-6560
Fax Number	:

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

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	08/27/2025

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