MEDICARE: MS. RACHEL S. GONICK-MEFFERD 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
1	171100000X	Acupuncturist	14571	CA

General Provider Information

NPI Number	:	1619247806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RACHEL S. GONICK-MEFFERD L.AC

Provider Business Mailing Address
First Line	:	4040 OLIVE POINT PL
Second Line	:
City	:	CLAREMONT
State	:	CA
Zip	:	91711-1412
Country	:	US
Telephone Number	:	909-568-8511
Fax Number	:

Provider Business Practice Location Address
First Line	:	363 S INDIAN HILL BLVD
Second Line	:
City	:	CLAREMONT
State	:	CA
Zip	:	91711-5224
Country	:	US
Telephone Number	:	909-568-0600
Fax Number	:

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

Provider Enumeration Date	:	01/05/2012
Last Update Date	:	01/05/2012

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Directions to “ MS. RACHEL S. GONICK-MEFFERD L.AC” Practice Location

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