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NPI Code Detail

MEDICARE: DEYNA LIBIRAN LAC

MEDICARE: DEYNA LIBIRAN LAC
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
1171100000XAcupuncturist17379CA

General Provider Information

NPI Number : 1801346523
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEYNA LIBIRAN LAC
Provider Business Mailing Address
First Line : 2515 CAMINO DEL RIO S STE 110
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-3714
Country : US
Telephone Number : 619-688-0061
Fax Number :
Provider Business Practice Location Address
First Line : 2515 CAMINO DEL RIO S STE 110
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-3714
Country : US
Telephone Number : 619-688-0061
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2016
Last Update Date : 10/05/2016

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Directions to “ DEYNA LIBIRAN LAC” Practice Location

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