MEDICARE: MS. MONICA DUMALA FOITZIK 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	AC16860	CA

General Provider Information

NPI Number	:	1235645938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MONICA DUMALA FOITZIK L.AC.

Provider Business Mailing Address
First Line	:	3861 RIVIERA DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92109-6302
Country	:	US
Telephone Number	:	760-696-1993
Fax Number	:

Provider Business Practice Location Address
First Line	:	1707 GRAND AVE STE A
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92109-4469
Country	:	US
Telephone Number	:	760-696-1993
Fax Number	:

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

Provider Enumeration Date	:	12/18/2017
Last Update Date	:	12/18/2017

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