MEDICARE: LINDA DIANE GRUBER 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	6534	CA

General Provider Information

NPI Number	:	1154634046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA DIANE GRUBER L.AC.

Provider Business Mailing Address
First Line	:	1404 CHURCH ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94131-2016
Country	:	US
Telephone Number	:	415-305-9889
Fax Number	:

Provider Business Practice Location Address
First Line	:	1404 CHURCH ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94131-2016
Country	:	US
Telephone Number	:	415-305-9889
Fax Number	:

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

Provider Enumeration Date	:	07/20/2010
Last Update Date	:	07/20/2010

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Directions to “ LINDA DIANE GRUBER L.AC.” Practice Location

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