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NPI Code Detail

MEDICARE: JONATHAN WHEELER L.AC.

MEDICARE: JONATHAN WHEELER 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
1171100000XAcupuncturist6900CA

General Provider Information

NPI Number : 1740578814
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN WHEELER L.AC.
Provider Business Mailing Address
First Line : 862 FOLSOM ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94107-1123
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 862 FOLSOM ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94107-1123
Country : US
Telephone Number : 415-350-3655
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2011
Last Update Date : 07/11/2011

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Directions to “ JONATHAN WHEELER L.AC.” Practice Location

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