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NPI Code Detail

MEDICARE: MR. JEFFERY PRESCOTT AVERILL L.AC.

MEDICARE:  MR. JEFFERY PRESCOTT AVERILL  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
1171100000XAcupuncturistAC 7343CA

General Provider Information

NPI Number : 1750520607
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JEFFERY PRESCOTT AVERILL L.AC.
Provider Business Mailing Address
First Line : 5808 E NAPLES PLZ
Second Line :
City : LONG BEACH
State : CA
Zip : 90803-5039
Country : US
Telephone Number : 562-856-9294
Fax Number : 562-684-4441
Provider Business Practice Location Address
First Line : 5808 E NAPLES PLZ
Second Line :
City : LONG BEACH
State : CA
Zip : 90803-5039
Country : US
Telephone Number : 562-856-9294
Fax Number : 562-684-4441
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2009
Last Update Date : 02/17/2009

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Directions to “ MR. JEFFERY PRESCOTT AVERILL L.AC.” Practice Location

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