MEDICARE: NEGEEN KIARASHI LAC

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	17685	CA

General Provider Information

NPI Number	:	1376045807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEGEEN KIARASHI LAC

Provider Business Mailing Address
First Line	:	6425 TREFOIL AVE
Second Line	:
City	:	OAK PARK
State	:	CA
Zip	:	91377-1230
Country	:	US
Telephone Number	:	818-404-2425
Fax Number	:

Provider Business Practice Location Address
First Line	:	28047 DOROTHY DR STE 208
Second Line	:
City	:	AGOURA HILLS
State	:	CA
Zip	:	91301-4955
Country	:	US
Telephone Number	:	818-964-1875
Fax Number	:

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

Provider Enumeration Date	:	02/28/2018
Last Update Date	:	02/28/2018

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Directions to “ NEGEEN KIARASHI LAC” Practice Location

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