MEDICARE: JACINTHA ROEMER L.AC., LMT

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	15459	CA

General Provider Information

NPI Number	:	1801279237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACINTHA ROEMER L.AC., LMT

Provider Business Mailing Address
First Line	:	4221 4TH AVE
Second Line	:	APT. I
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-1442
Country	:	US
Telephone Number	:	612-245-7781
Fax Number	:

Provider Business Practice Location Address
First Line	:	4221 4TH AVE
Second Line	:	APT. I
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-1442
Country	:	US
Telephone Number	:	619-721-7266
Fax Number	:

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

Provider Enumeration Date	:	07/02/2015
Last Update Date	:	07/02/2015

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