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NPI Code Detail

MEDICARE: MRS. ROSANNA VICTORIA GREGORY LAC

MEDICARE: MRS. ROSANNA VICTORIA GREGORY LAC
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
1171100000XAcupuncturistCA10948CA

General Provider Information

NPI Number : 1073720546
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ROSANNA VICTORIA GREGORY LAC
Provider Business Mailing Address
First Line : 2832 E CHAPMAN AVE
Second Line :
City : ORANGE
State : CA
Zip : 92869-3211
Country : US
Telephone Number : 714-532-2837
Fax Number : 714-532-2917
Provider Business Practice Location Address
First Line : 2832 E CHAPMAN AVE
Second Line :
City : ORANGE
State : CA
Zip : 92869-3211
Country : US
Telephone Number : 714-532-2837
Fax Number : 714-532-2917
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. ROSANNA VICTORIA GREGORY LAC” Practice Location

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