MEDICARE: MRS. BEHNAZ FORAT 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	AC 4962	CA

General Provider Information

NPI Number	:	1538335567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BEHNAZ FORAT L.AC.

Provider Business Mailing Address
First Line	:	8909 W OLYMPIC BLVD
Second Line	:	SUITE 150
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-3551
Country	:	US
Telephone Number	:	310-289-5924
Fax Number	:

Provider Business Practice Location Address
First Line	:	8909 W OLYMPIC BLVD
Second Line	:	SUITE 150
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-3551
Country	:	US
Telephone Number	:	310-289-5924
Fax Number	:

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

Provider Enumeration Date	:	04/30/2008
Last Update Date	:	04/30/2008

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