MEDICARE: MR. JAIME MAURICIO DEGUZMAN JR. LAC

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 10241	CA

General Provider Information

NPI Number	:	1568428704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAIME MAURICIO DEGUZMAN JR. LAC

Provider Business Mailing Address
First Line	:	10966 MORNING STAR LN
Second Line	:
City	:	NEVADA CITY
State	:	CA
Zip	:	95959-9796
Country	:	US
Telephone Number	:	530-885-2909
Fax Number	:

Provider Business Practice Location Address
First Line	:	3720 GRASS VALLEY HWY
Second Line	:
City	:	AUBURN
State	:	CA
Zip	:	95602-2002
Country	:	US
Telephone Number	:	530-885-2909
Fax Number	:

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

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	11/25/2008

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