MEDICARE: MR. ANDREW CHRISTENBERRY WHITELAW 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	18209	CA

General Provider Information

NPI Number	:	1285117200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANDREW CHRISTENBERRY WHITELAW LAC

Provider Business Mailing Address
First Line	:	1322 ELECTRIC AVE APT 2
Second Line	:
City	:	VENICE
State	:	CA
Zip	:	90291-3762
Country	:	US
Telephone Number	:	310-766-0841
Fax Number	:

Provider Business Practice Location Address
First Line	:	3201 N SEPULVEDA BLVD STE A
Second Line	:
City	:	MANHATTAN BEACH
State	:	CA
Zip	:	90266-2463
Country	:	US
Telephone Number	:	310-620-9090
Fax Number	:

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

Provider Enumeration Date	:	09/14/2018
Last Update Date	:	08/25/2023

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