MEDICARE: MR. ALBERT SALOPEK LAC ATC

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	12204	CA
2	2255A2300X	Athletic Trainer		CA

General Provider Information

NPI Number	:	1821178500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALBERT SALOPEK LAC ATC

Provider Business Mailing Address
First Line	:	1440 BUSH ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94109-5521
Country	:	US
Telephone Number	:	650-787-1119
Fax Number	:	415-567-3090

Provider Business Practice Location Address
First Line	:	1440 BUSH ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94109-5521
Country	:	US
Telephone Number	:	650-787-1119
Fax Number	:	415-567-3090

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

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	12/13/2007

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