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NPI Code Detail

MEDICARE: JONATHAN MATTHEW BRAND L.AC.

MEDICARE: JONATHAN MATTHEW BRAND 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
1171100000XAcupuncturist16076CA

General Provider Information

NPI Number : 1972923852
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN MATTHEW BRAND L.AC.
Provider Business Mailing Address
First Line : 453 S SPRING ST
Second Line : SUITE 320
City : LOS ANGELES
State : CA
Zip : 90013-2013
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 453 S SPRING ST
Second Line : SUITE 320
City : LOS ANGELES
State : CA
Zip : 90013-2013
Country : US
Telephone Number : 213-375-8472
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2014
Last Update Date : 11/04/2015

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Directions to “ JONATHAN MATTHEW BRAND L.AC.” Practice Location

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