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NPI Code Detail

MEDICARE: DHANELL A. AZADA L.AC.

MEDICARE: DHANELL A. AZADA L.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
1171100000XAcupuncturist8727CA

General Provider Information

NPI Number : 1871606632
Entity Type Code : Individual
Provider Name (Legal Business Name) : DHANELL A. AZADA L.AC.
Provider Business Mailing Address
First Line : 1920 W WARDLOW RD
Second Line :
City : LONG BEACH
State : CA
Zip : 90810-2041
Country : US
Telephone Number : 562-858-1516
Fax Number :
Provider Business Practice Location Address
First Line : 6423 E PACIFIC COAST HWY
Second Line :
City : LONG BEACH
State : CA
Zip : 90803-4201
Country : US
Telephone Number : 562-795-6680
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2006
Last Update Date : 07/08/2007

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Directions to “ DHANELL A. AZADA L.AC.” Practice Location

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