MEDICARE: MR. STEPHEN JAMES COLEMAN LAC LICENSED ACUPUNC

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	AC2689	CA

General Provider Information

NPI Number	:	1790998227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEPHEN JAMES COLEMAN LAC LICENSED ACUPUNC

Provider Business Mailing Address
First Line	:	315 A 29TH STREET
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94131-2304
Country	:	US
Telephone Number	:	415-824-5993
Fax Number	:	415-282-3773

Provider Business Practice Location Address
First Line	:	315 A 29TH STREET
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94131-2304
Country	:	US
Telephone Number	:	415-824-5993
Fax Number	:	415-282-3773

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

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	07/08/2007

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