=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548716897
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMES SKOIEN DR. H.C., L.AC.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/28/2016
-----------------------------------------------------
Last Update Date | 08/28/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 42718 MOONRIDGE ROAD
-----------------------------------------------------
City | BIG BEAR LAKE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92315-3705
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-213-7301
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 3705 42718 MOONRIDGE ROAD
-----------------------------------------------------
City | BIG BEAR LAKE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92315-3705
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-213-7301
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | AC16706
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------