MEDICARE: NATHALIE SHAPIRO 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
1	171100000X	Acupuncturist	AC19147	CA

General Provider Information

NPI Number	:	1902472855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATHALIE SHAPIRO L.AC

Provider Business Mailing Address
First Line	:	PO BOX 1176
Second Line	:
City	:	CARDIFF
State	:	CA
Zip	:	92007-7176
Country	:	US
Telephone Number	:	760-533-4803
Fax Number	:

Provider Business Practice Location Address
First Line	:	11340 W OLYMPIC BLVD STE 138
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-1611
Country	:	US
Telephone Number	:	310-477-3335
Fax Number	:

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

Provider Enumeration Date	:	06/01/2021
Last Update Date	:	06/01/2021

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