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General NPI Number Information
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NPI Number | 1093238644
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Entity Type | Individual
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Provider Name | GREGORY SCOTT KLEIN L.AC.
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Gender | Male
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Dates
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Enumeration Date | 07/25/2017
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Last Update Date | 07/25/2017
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Provider Practice Location Address
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Address Line | 155 MAIN ST
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City | WOODLAND
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State | CA
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Zip | 95695-3125
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Country | US
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Telephone | 530-650-8119
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Fax |
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Provider Business Mailing Address
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Address Line | 1159 STAFFORD DR
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City | CUPERTINO
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State | CA
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Zip | 95014-4968
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC17204
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License Number State | CA
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