MEDICARE: JONATHAN FRANCIS LENAHAN

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	17145	CA

General Provider Information

NPI Number	:	1275175762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN FRANCIS LENAHAN

Provider Business Mailing Address
First Line	:	2928 MURAT ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-2446
Country	:	US
Telephone Number	:	908-433-4047
Fax Number	:

Provider Business Practice Location Address
First Line	:	1826 S COAST HWY
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92054-5322
Country	:	US
Telephone Number	:	760-453-5179
Fax Number	:

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

Provider Enumeration Date	:	10/16/2019
Last Update Date	:	10/16/2019

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Directions to “ JONATHAN FRANCIS LENAHAN ” Practice Location

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