MEDICARE: ANNE SHELTON CRUTE DAOM

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	AC17248	CA

General Provider Information

NPI Number	:	1942020441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE SHELTON CRUTE DAOM

Provider Business Mailing Address
First Line	:	1508 WALNUT ST STE D
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94709-1564
Country	:	US
Telephone Number	:	415-527-7142
Fax Number	:	415-527-7142

Provider Business Practice Location Address
First Line	:	1508 WALNUT ST STE D
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94709-1564
Country	:	US
Telephone Number	:	415-527-7142
Fax Number	:	415-527-7142

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

Provider Enumeration Date	:	10/10/2024
Last Update Date	:	10/10/2024

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