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NPI Code Detail

MEDICARE: MR. MICHAEL SUTHERLAND CLAUSON L.AC.

MEDICARE:  MR. MICHAEL SUTHERLAND CLAUSON  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
1171100000XAcupuncturistAC 2865CA

General Provider Information

NPI Number : 1437213436
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL SUTHERLAND CLAUSON L.AC.
Provider Business Mailing Address
First Line : 975 SERENO DR
Second Line : BAYVIEW SOUTH
City : VALLEJO
State : CA
Zip : 94589-2441
Country : US
Telephone Number : 707-651-2749
Fax Number :
Provider Business Practice Location Address
First Line : 975 SERENO DR
Second Line : BAYVIEW SOUTH
City : VALLEJO
State : CA
Zip : 94589-2441
Country : US
Telephone Number : 707-651-2749
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2006
Last Update Date : 07/08/2007

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Directions to “ MR. MICHAEL SUTHERLAND CLAUSON L.AC.” Practice Location

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