MEDICARE: MS. THALIA LIRAIN-HAFT L.AC.

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	4582	CA

General Provider Information

NPI Number	:	1093879033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. THALIA LIRAIN-HAFT L.AC.

Provider Business Mailing Address
First Line	:	4222 TERRACE ST
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94611-5128
Country	:	US
Telephone Number	:	510-547-3560
Fax Number	:	510-547-1805

Provider Business Practice Location Address
First Line	:	2006 DWIGHT WAY
Second Line	:	STE 204
City	:	BERKELEY
State	:	CA
Zip	:	94704-2633
Country	:	US
Telephone Number	:	510-547-3560
Fax Number	:	510-547-1805

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2006
Last Update Date	:	07/08/2007

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