MEDICARE: DAVID CARUSO-RADIN LAC

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	AC11741	CA

General Provider Information

NPI Number	:	1942489414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID CARUSO-RADIN LAC

Provider Business Mailing Address
First Line	:	1491 HOPKINS ST
Second Line	:	SUITE A
City	:	BERKELEY
State	:	CA
Zip	:	94702-1244
Country	:	US
Telephone Number	:	510-684-0926
Fax Number	:

Provider Business Practice Location Address
First Line	:	1491 HOPKINS ST
Second Line	:	SUITE A
City	:	BERKELEY
State	:	CA
Zip	:	94702-1244
Country	:	US
Telephone Number	:	510-684-0926
Fax Number	:

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

Provider Enumeration Date	:	10/31/2007
Last Update Date	:	10/31/2007

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Directions to “ DAVID CARUSO-RADIN LAC” Practice Location

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