MEDICARE: DAISY DONG L. AC. CMD

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	566	CO

General Provider Information

NPI Number	:	1396796082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAISY DONG L. AC. CMD

Provider Business Mailing Address
First Line	:	1325 S COLORADO BLVD
Second Line	:	SUITE B-012
City	:	DENVER
State	:	CO
Zip	:	80222-3303
Country	:	US
Telephone Number	:	303-949-8424
Fax Number	:

Provider Business Practice Location Address
First Line	:	1325 S COLORADO BLVD
Second Line	:	SUITE B-012
City	:	DENVER
State	:	CO
Zip	:	80222-3303
Country	:	US
Telephone Number	:	303-949-8424
Fax Number	:

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

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	03/20/2020

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