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R SCOTT NANAMURA LAC

>> Acupuncturist >> Other Service Providers

Registrant NPI Number: 1609056662

Individual Registrant:
 R SCOTT NANAMURA LAC
Gender: M
Not Sole Proprietor

Location and contact information for practice:
2489 LAKE TAHOE BLVD SUITE 28 S LAKE TAHOE, CA 96150-7728 US
Tel: 530-541-6392  Fax: --

Contact information for business:
PO BOX 9579  S LAKE TAHOE, CA 96158-2579 US
Tel: 530-541-6392  Fax: --

Registration Information:
NPI: 1609056662
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y171100000XOther Service Providers
Acupuncturist
CAAC5974

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
CALIFORNIA LAC LICENSEAC5974CA01




HEALTH CARE JOBS CA - Page 1



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