Provider Demographics
NPI:1033496021
Name:ENG, DANIEL (LAC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:ENG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 FRANKLIN ST STE 500
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-2926
Mailing Address - Country:US
Mailing Address - Phone:510-817-0680
Mailing Address - Fax:
Practice Address - Street 1:1904 FRANKLIN ST STE 500
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-2926
Practice Address - Country:US
Practice Address - Phone:510-817-0680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 14479171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist