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NPI 1972713949

NPI 1972713949 : DEAN MILITELLO L.AC. : SAN FRANCISCO, CA

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General NPI Number Information
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    NPI Number           |    1972713949
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    Entity Type          |    Individual 
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    Provider Name        |    DEAN MILITELLO L.AC.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/22/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    4255 18TH ST 
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    City                 |    SAN FRANCISCO
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    State                |    CA
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    Zip                  |    94114-2409
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    Country              |    US
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    Telephone            |    415-626-6231
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4255 18TH ST 
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    City                 |    SAN FRANCISCO
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    State                |    CA
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    Zip                  |    94114-2409
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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       |    6888
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    License Number State |    CA
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