MEDICARE: TERESA MARIE SOHONI 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	171100000X	Acupuncturist	7969	CA

General Provider Information

NPI Number	:	1376617589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA MARIE SOHONI L.AC.

Provider Business Mailing Address
First Line	:	20101 SW BIRCH ST STE 110
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-1749
Country	:	US
Telephone Number	:	949-631-2200
Fax Number	:	949-631-2299

Provider Business Practice Location Address
First Line	:	425 OLD NEWPORT BLVD
Second Line	:	SUITE B
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663-4250
Country	:	US
Telephone Number	:	714-337-5532
Fax Number	:

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

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	03/21/2019

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