MEDICARE: RITA HUANG L. AC., OMD

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#5122	CA

General Provider Information

NPI Number	:	1629145016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RITA HUANG L. AC., OMD

Provider Business Mailing Address
First Line	:	3445 MIDWAY DR STE J
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92110-4921
Country	:	US
Telephone Number	:	619-223-8988
Fax Number	:	619-223-9898

Provider Business Practice Location Address
First Line	:	3445 MIDWAY DR STE J
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92110-4921
Country	:	US
Telephone Number	:	619-223-8988
Fax Number	:	619-223-9898

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

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	07/08/2007

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