MEDICARE: AMANJEET KAUR SAHOTA NP, L.AC, RN

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	363L00000X	Nurse Practitioner	95003535	CA
2	163W00000X	Registered Nurse	95059393	CA
3	171100000X	Acupuncturist	AC19508	CA

General Provider Information

NPI Number	:	1669172318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANJEET KAUR SAHOTA NP, L.AC, RN

Provider Business Mailing Address
First Line	:	11990 SAN VICENTE BLVD # 250
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-6608
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11990 SAN VICENTE BLVD # 250
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-6608
Country	:	US
Telephone Number	:	530-918-8189
Fax Number	:

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

Provider Enumeration Date	:	03/09/2023
Last Update Date	:	05/02/2023

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