MEDICARE: SUZANNE PIPKIN 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	16112	CA

General Provider Information

NPI Number	:	1760893739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE PIPKIN L.AC.

Provider Business Mailing Address
First Line	:	4833 BRIGHTON AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92107-2517
Country	:	US
Telephone Number	:	619-787-4353
Fax Number	:

Provider Business Practice Location Address
First Line	:	1804 CABLE ST STE B
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92107-3141
Country	:	US
Telephone Number	:	619-787-4353
Fax Number	:

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

Provider Enumeration Date	:	05/13/2014
Last Update Date	:	05/13/2014

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