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NPI Code Detail

MEDICARE: DR. MIAN LONG L. AC

MEDICARE:  DR. MIAN  LONG  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
1171100000XAcupuncturistACU 722HI
2171100000XAcupuncturist1049NY

General Provider Information

NPI Number : 1255484622
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MIAN LONG L. AC
Provider Business Mailing Address
First Line : 2169 MOTT-SMITH DR
Second Line :
City : HONOLULU
State : HI
Zip : 96822-2564
Country : US
Telephone Number : 808-599-1870
Fax Number : 402-817-3684
Provider Business Practice Location Address
First Line : 651 ILALO ST
Second Line : SUITE 101
City : HONOLULU
State : HI
Zip : 96813-5525
Country : US
Telephone Number : 808-692-0908
Fax Number : 808-692-1958
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2007
Last Update Date : 12/27/2007

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Directions to “ DR. MIAN LONG L. AC” Practice Location

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