MEDICARE: THE MERIDIAN CENTER

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	AC1450	CA

General Provider Information

NPI Number	:	1346514205
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE MERIDIAN CENTER

Provider Business Mailing Address
First Line	:	506 SANTA MONICA BLVD
Second Line	:	SUITE 227
City	:	SANTA MONICA
State	:	CA
Zip	:	90401-2434
Country	:	US
Telephone Number	:	310-395-9525
Fax Number	:	310-395-9022

Provider Business Practice Location Address
First Line	:	506 SANTA MONICA BLVD
Second Line	:	SUITE 227
City	:	SANTA MONICA
State	:	CA
Zip	:	90401-2434
Country	:	US
Telephone Number	:	310-395-9525
Fax Number	:	310-395-9022

Authorized Official
Title or Position	:	PRINCIPLE
Name	:	JULIAN LANGE
Credential	:	OMD, LAC
Telephone Number	:	310-395-9525

Provider Enumeration Date	:	02/23/2012
Last Update Date	:	02/23/2012

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Directions to “THE MERIDIAN CENTER ” Practice Location

Language	Start Address	Practice Location

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