Healthcare Provider Details

I. General information

NPI: 1548716897
Provider Name (Legal Business Name): JAMES SKOIEN DR. H.C., L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2016
Last Update Date: 08/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42718 MOONRIDGE ROAD
BIG BEAR LAKE CA
92315-3705
US

IV. Provider business mailing address

PO BOX 3705 42718 MOONRIDGE ROAD
BIG BEAR LAKE CA
92315-3705
US

V. Phone/Fax

Practice location:
  • Phone: 909-213-7301
  • Fax:
Mailing address:
  • Phone: 909-213-7301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC16706
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: