MEDICARE: ACUPUNCTURE PAIN RELIEF, INC.

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	AC8486	CA

General Provider Information

NPI Number	:	1073880753
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACUPUNCTURE PAIN RELIEF, INC.

Provider Business Mailing Address
First Line	:	15550 ROCKFIELD BLVD
Second Line	:	B220
City	:	IRVINE
State	:	CA
Zip	:	92618-2720
Country	:	US
Telephone Number	:	949-598-9999
Fax Number	:

Provider Business Practice Location Address
First Line	:	1447 SANTA FE AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90813-1249
Country	:	US
Telephone Number	:	805-405-1250
Fax Number	:	661-363-6921

Authorized Official
Title or Position	:	OWNER/PROVIDER
Name	:	DR. DIANA ROMAN
Credential	:	L.A.C.
Telephone Number	:	805-450-1250

Provider Enumeration Date	:	11/22/2011
Last Update Date	:	11/22/2011

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