MEDICARE: DR. DONG QING KE ACUPUNCTURIST

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		CA

General Provider Information

NPI Number	:	1538224191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONG QING KE ACUPUNCTURIST

Provider Business Mailing Address
First Line	:	12340 SANTA MONICA BLVD
Second Line	:	#218
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-2500
Country	:	US
Telephone Number	:	310-826-5878
Fax Number	:

Provider Business Practice Location Address
First Line	:	12340 SANTA MONICA BLVD
Second Line	:	#218
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-2500
Country	:	US
Telephone Number	:	310-826-5878
Fax Number	:

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

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	07/08/2007

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