MEDICARE: MRS. KARIN LIPMAN NASSAR 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	AC12405	CA

General Provider Information

NPI Number	:	1982849444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KARIN LIPMAN NASSAR L.AC.

Provider Business Mailing Address
First Line	:	2901 OCEAN PARK BLVD
Second Line	:	#207
City	:	SANTA MONICA
State	:	CA
Zip	:	90405-2919
Country	:	US
Telephone Number	:	310-447-4687
Fax Number	:

Provider Business Practice Location Address
First Line	:	2901 OCEAN PARK BLVD
Second Line	:	#207
City	:	SANTA MONICA
State	:	CA
Zip	:	90405-2919
Country	:	US
Telephone Number	:	310-447-4687
Fax Number	:

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

Provider Enumeration Date	:	12/11/2008
Last Update Date	:	08/09/2011

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