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NPI Code Detail

MEDICARE: MARET IRENE KUNZE LAC OMD

MEDICARE:   MARET IRENE KUNZE  LAC OMD
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
1171100000XAcupuncturistAC2747CA

General Provider Information

NPI Number : 1114086022
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARET IRENE KUNZE LAC OMD
Provider Business Mailing Address
First Line : 105 EAST 15TH STREET
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92663-4555
Country : US
Telephone Number : 949-675-2729
Fax Number : 949-675-2961
Provider Business Practice Location Address
First Line : 105 EAST 15TH STREET
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92663-4555
Country : US
Telephone Number : 949-675-2729
Fax Number : 949-675-2961
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2006
Last Update Date : 07/08/2007

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Directions to “ MARET IRENE KUNZE LAC OMD” Practice Location

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