MEDICARE: DR. AMIR NABET DACCHM

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	20057	CA

General Provider Information

NPI Number	:	1467204230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMIR NABET DACCHM

Provider Business Mailing Address
First Line	:	2339 AVENIDA SEVILLA APT C
Second Line	:
City	:	LAGUNA WOODS
State	:	CA
Zip	:	92637-0836
Country	:	US
Telephone Number	:	949-229-5240
Fax Number	:

Provider Business Practice Location Address
First Line	:	23028 LAKE FOREST DR STE D
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-1323
Country	:	US
Telephone Number	:	949-229-5240
Fax Number	:

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

Provider Enumeration Date	:	04/03/2024
Last Update Date	:	07/05/2024

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