MEDICARE: MS. LINDA LYMAN 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	AC 8227	CA

General Provider Information

NPI Number	:	1952436107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LINDA LYMAN L.AC.

Provider Business Mailing Address
First Line	:	505 SUZANNE ST
Second Line	:
City	:	RIDGECREST
State	:	CA
Zip	:	93555-4926
Country	:	US
Telephone Number	:	760-371-1520
Fax Number	:	760-371-1520

Provider Business Practice Location Address
First Line	:	751 S RICHMOND RD
Second Line	:	SUITE G
City	:	RIDGECREST
State	:	CA
Zip	:	93555-8217
Country	:	US
Telephone Number	:	760-371-1520
Fax Number	:	760-371-1520

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

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	07/08/2007

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