MEDICARE: OPTIMA ACUPUNCTURE AND WELLBEING LLC

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

General Provider Information

NPI Number	:	1942163332
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIMA ACUPUNCTURE AND WELLBEING LLC

Provider Business Mailing Address
First Line	:	61396 S HIGHWAY 97 STE 205
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97702-2159
Country	:	US
Telephone Number	:	541-390-6055
Fax Number	:

Provider Business Practice Location Address
First Line	:	61396 S HIGHWAY 97 STE 205
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97702-2159
Country	:	US
Telephone Number	:	541-390-6055
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JOEL AMEZCUA
Credential	:	LAC
Telephone Number	:	541-390-6055

Provider Enumeration Date	:	12/03/2025
Last Update Date	:	12/03/2025

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Directions to “OPTIMA ACUPUNCTURE AND WELLBEING LLC ” Practice Location

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