MEDICARE: ALEXANDRA M BRUEHL 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	16160	CA

General Provider Information

NPI Number	:	1598167140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA M BRUEHL L.AC.

Provider Business Mailing Address
First Line	:	943 N VENDOME ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90026-2833
Country	:	US
Telephone Number	:	323-484-4560
Fax Number	:

Provider Business Practice Location Address
First Line	:	4306 MELROSE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90029-3511
Country	:	US
Telephone Number	:	323-484-4560
Fax Number	:

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

Provider Enumeration Date	:	09/25/2014
Last Update Date	:	01/12/2022

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