MEDICARE: MIAO MIAO

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	19379	CA

General Provider Information

NPI Number	:	1700533981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIAO MIAO

Provider Business Mailing Address
First Line	:	6280 COLGATE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-3126
Country	:	US
Telephone Number	:	310-560-1526
Fax Number	:

Provider Business Practice Location Address
First Line	:	6280 COLGATE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-3126
Country	:	US
Telephone Number	:	310-560-1526
Fax Number	:

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

Provider Enumeration Date	:	03/07/2022
Last Update Date	:	03/07/2022

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Directions to “ MIAO MIAO ” Practice Location

Language	Start Address	Practice Location

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