MEDICARE: DR. YUKO CROSSWHITE D.O.M.

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	847	NM

General Provider Information

NPI Number	:	1811000896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YUKO CROSSWHITE D.O.M.

Provider Business Mailing Address
First Line	:	2105 PASEO PONDEROSA
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87501-8390
Country	:	US
Telephone Number	:	505-820-1956
Fax Number	:

Provider Business Practice Location Address
First Line	:	1421 LUISA ST STE J
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-4073
Country	:	US
Telephone Number	:	505-603-2461
Fax Number	:

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

Provider Enumeration Date	:	08/16/2006
Last Update Date	:	05/15/2008

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Directions to “ DR. YUKO CROSSWHITE D.O.M.” Practice Location

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