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NPI Code Detail

MEDICARE: MS. SOPHIA OSBURN LAC

MEDICARE: MS. SOPHIA OSBURN 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
1171100000XAcupuncturistAC17308CA

General Provider Information

NPI Number : 1275085060
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SOPHIA OSBURN LAC
Provider Business Mailing Address
First Line : PO BOX 3212
Second Line :
City : SEAL BEACH
State : CA
Zip : 90740-2212
Country : US
Telephone Number : 562-888-4998
Fax Number :
Provider Business Practice Location Address
First Line : 550 PACIFIC COAST HWY STE 207
Second Line :
City : SEAL BEACH
State : CA
Zip : 90740-6657
Country : US
Telephone Number : 562-888-4998
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2016
Last Update Date : 04/03/2019

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