MEDICARE: YU-SHIEN NI LAC, DACCHM

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	9197	CA

General Provider Information

NPI Number	:	1760338016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YU-SHIEN NI LAC, DACCHM

Provider Business Mailing Address
First Line	:	1240 6TH ST
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90401-1602
Country	:	US
Telephone Number	:	310-917-2200
Fax Number	:

Provider Business Practice Location Address
First Line	:	1240 6TH ST
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90401-1602
Country	:	US
Telephone Number	:	310-917-2200
Fax Number	:

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

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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