MEDICARE: NIRALI PATEL 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	AC 16883	CA

General Provider Information

NPI Number	:	1215302294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIRALI PATEL L.AC

Provider Business Mailing Address
First Line	:	1010 SAN ANSELMO AVE S
Second Line	:
City	:	SAN BRUNO
State	:	CA
Zip	:	94066-5312
Country	:	US
Telephone Number	:	206-330-1548
Fax Number	:

Provider Business Practice Location Address
First Line	:	1098 FOSTER CITY BLVD STE 204
Second Line	:
City	:	FOSTER CITY
State	:	CA
Zip	:	94404-2345
Country	:	US
Telephone Number	:	650-667-1548
Fax Number	:

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

Provider Enumeration Date	:	12/02/2015
Last Update Date	:	02/28/2019

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