MEDICARE: MS. SVETLANA KASMAN R.D., 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	133V00000X	Registered Dietitian	726996	CA
2	171100000X	Acupuncturist	5404	CA

General Provider Information

NPI Number	:	1306843552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SVETLANA KASMAN R.D., L.AC.

Provider Business Mailing Address
First Line	:	425 S FAIRFAX AVE
Second Line	:	SUITE 210
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-3541
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7855 SANTA MONICA BLVD
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90046-5344
Country	:	US
Telephone Number	:	310-275-3835
Fax Number	:

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

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	02/24/2015

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