Healthcare Provider Details

I. General information

NPI: 1922148535
Provider Name (Legal Business Name): BARBRA E. MACNAIR L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3021 TELEGRAPH AVE SUITE B
BERKELEY CA
94705-2072
US

IV. Provider business mailing address

3021 TELEGRAPH AVE SUITE B
BERKELEY CA
94705-2072
US

V. Phone/Fax

Practice location:
  • Phone: 510-649-8054
  • Fax: 510-649-9782
Mailing address:
  • Phone: 510-649-8054
  • Fax: 510-649-9782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC2923
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: