MEDICARE: ACUPUNCTURE BY HOMA, INC

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	12590	CA

General Provider Information

NPI Number	:	1417303033
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACUPUNCTURE BY HOMA, INC

Provider Business Mailing Address
First Line	:	PO BOX 1915
Second Line	:
City	:	MANHATTAN BEACH
State	:	CA
Zip	:	90267-1915
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	234 S PACIFIC COAST HWY
Second Line	:	SUITE 205
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-3383
Country	:	US
Telephone Number	:	310-372-5555
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HOMA SAJADIAN SIKON
Credential	:
Telephone Number	:	310-936-7681

Provider Enumeration Date	:	05/12/2016
Last Update Date	:	05/12/2016

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