MEDICARE: SYLVVARI RYU'XTIEL 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	16542	CA

General Provider Information

NPI Number	:	1518354166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYLVVARI RYU'XTIEL L. AC

Provider Business Mailing Address
First Line	:	10914 PORTOBELO DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92124-1181
Country	:	US
Telephone Number	:	858-309-2037
Fax Number	:

Provider Business Practice Location Address
First Line	:	10914 PORTOBELO DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92124-1181
Country	:	US
Telephone Number	:	858-309-2037
Fax Number	:

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

Provider Enumeration Date	:	04/22/2015
Last Update Date	:	08/22/2020

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