MEDICARE: MRS. KATJA SUSANNE ZAMRIK

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	16224	CA

General Provider Information

NPI Number	:	1447656186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATJA SUSANNE ZAMRIK

Provider Business Mailing Address
First Line	:	2550 SHATTUCK AVE
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94704
Country	:	US
Telephone Number	:	510-666-8234
Fax Number	:	510-666-0111

Provider Business Practice Location Address
First Line	:	2550 SHATTUCK AVE
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94704
Country	:	US
Telephone Number	:	510-666-8234
Fax Number	:	510-666-0111

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

Provider Enumeration Date	:	11/07/2014
Last Update Date	:	11/07/2014

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