MEDICARE: CHANTAL LORRAINE DAVIS 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	13487	CA

General Provider Information

NPI Number	:	1730492174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHANTAL LORRAINE DAVIS L.AC.

Provider Business Mailing Address
First Line	:	3655 RUFFIN RD STE 200
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-1833
Country	:	US
Telephone Number	:	619-793-7030
Fax Number	:

Provider Business Practice Location Address
First Line	:	3655 RUFFIN RD STE 200
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-1833
Country	:	US
Telephone Number	:	619-793-7030
Fax Number	:

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

Provider Enumeration Date	:	07/14/2010
Last Update Date	:	08/16/2024

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Directions to “ CHANTAL LORRAINE DAVIS L.AC.” Practice Location

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