MEDICARE: ALEX STAMPBACH 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	AC17496	CA

General Provider Information

NPI Number	:	1568998524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEX STAMPBACH L. AC.

Provider Business Mailing Address
First Line	:	2610 EL CAMINO REAL # A
Second Line	:
City	:	CARLSBAD
State	:	CA
Zip	:	92008-1214
Country	:	US
Telephone Number	:	760-730-7315
Fax Number	:

Provider Business Practice Location Address
First Line	:	2610 EL CAMINO REAL # A
Second Line	:
City	:	CARLSBAD
State	:	CA
Zip	:	92008-1214
Country	:	US
Telephone Number	:	760-730-7315
Fax Number	:

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

Provider Enumeration Date	:	05/11/2017
Last Update Date	:	05/11/2017

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