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Organization
R SCOTT NANAMURA AC INC
Active
Organization
R SCOTT NANAMURA AC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
R SCOTT NANAMURA LAC (OWNER)
(530) 541-6392
Entity
Organization
Contact information
Practice address
2489 LAKE TAHOE BLVD, SUITE 28, S LAKE TAHOE, CA 96150-7728
(530) 541-6292
Mailing address
PO BOX 9579, S LAKE TAHOE, CA 96158-2579
(530) 541-6392
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC5974
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AC 5974
CALIFORNIA LAC LICENSE
CA
Enumeration date
11/07/2007
Last updated
11/07/2007
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