MEDICARE: MRS. JIAN MUNDAHL ACUPUNCTURIST

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	AC20425	CA

General Provider Information

NPI Number	:	1558223156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JIAN MUNDAHL ACUPUNCTURIST

Provider Business Mailing Address
First Line	:	1237 S VICTORIA AVE #253
Second Line	:
City	:	OXNARD
State	:	CA
Zip	:	93035
Country	:	US
Telephone Number	:	626-652-1213
Fax Number	:

Provider Business Practice Location Address
First Line	:	2104 RAYMOND AVE #12
Second Line	:
City	:	ALTADENA
State	:	CA
Zip	:	91001
Country	:	US
Telephone Number	:	626-652-1213
Fax Number	:

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

Provider Enumeration Date	:	12/02/2025
Last Update Date	:	12/02/2025

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