MEDICARE: WELL WOMEN ACUPUNCTURE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AC7797	CA

General Provider Information

NPI Number	:	1013239326
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELL WOMEN ACUPUNCTURE

Provider Business Mailing Address
First Line	:	11980 SAN VICENTE BLVD STE 112
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-6602
Country	:	US
Telephone Number	:	310-991-7797
Fax Number	:	310-826-3713

Provider Business Practice Location Address
First Line	:	11980 SAN VICENTE BLVD STE 112
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-6602
Country	:	US
Telephone Number	:	310-991-7797
Fax Number	:	310-826-3713

Authorized Official
Title or Position	:	OWNER
Name	:	DANICA THORNBERRY
Credential	:	L.AC.
Telephone Number	:	310-991-7797

Provider Enumeration Date	:	03/01/2010
Last Update Date	:	03/01/2010

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Directions to “WELL WOMEN ACUPUNCTURE ” Practice Location

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