MEDICARE: OSCAR SIERRA 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	235	GA

General Provider Information

NPI Number	:	1912146515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OSCAR SIERRA L.AC.

Provider Business Mailing Address
First Line	:	3057 PHARR COURT NORTH NW
Second Line	:	APT. J5
City	:	ATLANTA
State	:	GA
Zip	:	30305-2045
Country	:	US
Telephone Number	:	678-361-6523
Fax Number	:

Provider Business Practice Location Address
First Line	:	2964 PEACHTREE RD NW
Second Line	:	STE. 350
City	:	ATLANTA
State	:	GA
Zip	:	30305-2153
Country	:	US
Telephone Number	:	678-361-6523
Fax Number	:

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

Provider Enumeration Date	:	02/05/2009
Last Update Date	:	02/03/2012

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