MEDICARE: LAURA L. PARIS OMD, 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
1	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1194939678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA L. PARIS OMD, LAC

Provider Business Mailing Address
First Line	:	23693 CALABASAS RD
Second Line	:
City	:	CALABASAS
State	:	CA
Zip	:	91302-1502
Country	:	US
Telephone Number	:	818-225-5900
Fax Number	:	818-225-5905

Provider Business Practice Location Address
First Line	:	23693 CALABASAS RD
Second Line	:
City	:	CALABASAS
State	:	CA
Zip	:	91302-1502
Country	:	US
Telephone Number	:	818-225-5900
Fax Number	:	818-225-5905

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

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	07/09/2007

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