MEDICARE: DR. AMY FLEETMAN L.AC., O.M.D.

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	AC4970	CA

General Provider Information

NPI Number	:	1952328882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMY FLEETMAN L.AC., O.M.D.

Provider Business Mailing Address
First Line	:	12215 VENTURA BLVD
Second Line	:	SUITE 208
City	:	STUDIO CITY
State	:	CA
Zip	:	91604-2533
Country	:	US
Telephone Number	:	818-505-0816
Fax Number	:	818-505-8623

Provider Business Practice Location Address
First Line	:	12215 VENTURA BLVD
Second Line	:	SUITE 208
City	:	STUDIO CITY
State	:	CA
Zip	:	91604-2533
Country	:	US
Telephone Number	:	818-505-0816
Fax Number	:	818-505-8623

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

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	06/14/2026

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