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NPI Code Detail

MEDICARE: AMIELLE MOYER L.AC., H.T.C.P.

MEDICARE: AMIELLE MOYER L.AC., H.T.C.P.
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
1171100000XAcupuncturistAC 12552CA

General Provider Information

NPI Number : 1598905135
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMIELLE MOYER L.AC., H.T.C.P.
Provider Business Mailing Address
First Line : 3320 2ND AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92103-5612
Country : US
Telephone Number : 619-318-9930
Fax Number :
Provider Business Practice Location Address
First Line : 3320 2ND AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92103-5612
Country : US
Telephone Number : 619-318-9930
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2009
Last Update Date : 07/26/2010

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