MEDICARE: DR. JAYNE DABU DAOM,L.AC., DIPL.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	0121000588	VA

General Provider Information

NPI Number	:	1801127519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAYNE DABU DAOM,L.AC., DIPL.AC.

Provider Business Mailing Address
First Line	:	1492 S INDEPENDENCE BLVD STE 102
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-5252
Country	:	US
Telephone Number	:	757-431-0053
Fax Number	:	757-431-0053

Provider Business Practice Location Address
First Line	:	1492 S INDEPENDENCE BLVD STE 102
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-5252
Country	:	US
Telephone Number	:	757-431-0053
Fax Number	:	757-431-0053

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

Provider Enumeration Date	:	01/20/2010
Last Update Date	:	02/19/2025

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