MEDICARE: RYO EGUCHI 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	AC19214	CA

General Provider Information

NPI Number	:	1598427841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYO EGUCHI L.AC.

Provider Business Mailing Address
First Line	:	862 MOULTRIE ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-6072
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1452 VALENCIA ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-3717
Country	:	US
Telephone Number	:	415-815-9244
Fax Number	:

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

Provider Enumeration Date	:	10/13/2021
Last Update Date	:	10/13/2021

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